Southern Oregon Orthopedics, Medford, OR, USA; Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA.
OCM (Orthopädische Chirurgie München), München, Germany.
J Shoulder Elbow Surg. 2018 Jun;27(6):1139-1147. doi: 10.1016/j.jse.2017.12.020. Epub 2018 Feb 5.
Uncemented press-fit humeral stems were developed with the goal of decreasing operative time, preserving bone stock, and easing revision. In recent years, short stems and stemless humeral implants have also become available. These press-fit humeral implants have varying designs that can lead to changes in stress distribution in the proximal humerus. Such stress shielding manifests as bony adaptations and may affect long-term functional outcome and the ability to perform revision. However, current studies of humeral fixation during total shoulder arthroplasty are complicated because a variety of classification systems have been used to report findings. The purpose of this report is to review the current literature on press-fit fixation of the humeral component during total shoulder arthroplasty and propose minimum requirements for radiographic descriptions of stress shielding.
非骨水泥压配式肱骨柄的设计目的在于减少手术时间、保留骨质和便于翻修。近年来，短柄和无柄肱骨假体也已问世。这些压配式肱骨假体具有不同的设计，可能会导致肱骨近端的应力分布发生改变。这种应力遮挡表现为骨质适应性改变，可能会影响长期功能结果和翻修能力。然而，目前全肩关节置换术中肱骨固定的研究较为复杂，因为已经使用了多种分类系统来报告研究结果。本报告的目的是回顾全肩关节置换术中肱骨部件压配固定的现有文献，并提出关于应力遮挡的影像学描述的最低要求。
