Stautberg Eugene F, Jupiter Daniel C, Amin Arsalan, Qadeer Ali A, Ilahi Omer A
Department of Orthopedic Surgery and Rehabilitation, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0165, USA.
Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX, 77555, USA.
Int Orthop. 2017 Nov;41(11):2345-2351. doi: 10.1007/s00264-017-3599-7. Epub 2017 Aug 24.
In total shoulder arthroplasty (TSA), the optimum number of peripheral pegs required for stability in the glenoid component is unknown. This study compared the stability of two versus three peripheral pegs in cemented glenoid components possessing a central press-fit peg.
Six unmodified glenoid components with three peripheral pegs, a large, central press-fit peg and six modified glenoid components with one inferior peripheral peg sharply removed were cemented into bone substitute polyurethane blocks. A modified rocking-horse test was completed by comparing superior- and inferior-edge displacement before and after 100,000 vertical motion cycles. Then, a torsional failure test applied 2 N axial load, followed by a rotational force to the glenoid component at 0.5 °/s until failure.
Modified rocking-horse testing showed no statistically significant edge displacement at the superior or inferior aspect of the glenoid component before or after testing. During torsional testing, peak torque and degrees of rotation at failure also showed no significant difference.
Two peripheral pegs offer equivalent stability as three peripheral pegs, as assessed by cyclic rocking and rotational failure testing. Fewer peripheral pegs during glenoid component implantation may lead to less dissection, less strain on soft tissues and decreased operative time.
在全肩关节置换术（TSA）中，关节盂组件稳定所需的周边固定钉的最佳数量尚不清楚。本研究比较了在具有中央压配固定钉的骨水泥型关节盂组件中，两个与三个周边固定钉的稳定性。
将六个带有三个周边固定钉、一个大的中央压配固定钉的未改良关节盂组件，以及六个尖锐移除了一个下周边固定钉的改良关节盂组件，用骨水泥固定到骨替代聚氨酯块中。通过比较100,000次垂直运动循环前后上边缘和下边缘的位移，完成改良的摇马试验。然后，扭转失效试验施加2 N轴向载荷，接着以0.5°/s的速度对关节盂组件施加旋转力直至失效。
改良摇马试验显示，在测试前后，关节盂组件的上侧或下侧边缘位移在统计学上无显著差异。在扭转测试中，失效时的峰值扭矩和旋转度数也无显著差异。
通过循环摇摆和旋转失效测试评估，两个周边固定钉与三个周边固定钉具有同等的稳定性。在关节盂组件植入过程中使用更少的周边固定钉可能会减少解剖范围、减轻软组织的应变并缩短手术时间。
