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解剖型全肩关节置换术中使用小梁金属背衬的肩胛盂假体的结果。

Outcomes of Trabecular Metal-backed glenoid components in anatomic total shoulder arthroplasty.

机构信息

Greenville Health System, Greenville, SC, USA.

Hawkins Foundation, Greenville, SC, USA.

出版信息

J Shoulder Elbow Surg. 2018 Mar;27(3):493-498. doi: 10.1016/j.jse.2017.09.036.

Abstract

BACKGROUND

As glenoid failure is one of the primary causes of failure of anatomic total shoulder arthroplasty (TSA), Trabecular Metal-backed glenoid components have become popular. This study reports implant survival and clinical outcomes of patients who received a Trabecular Metal-backed glenoid component during primary anatomic TSA.

METHODS

Patients who underwent TSA with a Trabecular Metal-backed glenoid component by a single surgeon were identified and reviewed for clinical, radiographic, and patient-reported outcome measures with a minimum of 2 years' follow-up.

RESULTS

Of 47 patients identified, radiographic and clinical follow-up was available on 36 patients (77%). Average age was 66.36 years (range, 50-85 years), and the average follow-up 41 months (range, 24-66 months). Three patients showed signs of osteolysis, 4 had radiographic evidence of metal debris, and 1 patient had a catastrophic failure after a fall. Of the 47 TSAs, 5 (11%) were revised to a reverse TSA for subscapularis failure and pain. Visual analog scale for pain scores improved by an average of 4.4. At final follow-up, the average Single Assessment Numeric Evaluation score was 72.4; Penn satisfaction score, 7.5; Penn score, 70.35; and American Shoulder and Elbow Surgeons score, 69.23. Outcome scores were similar in the 7 patients with osteolysis or metal debris compared to those without.

CONCLUSION

Trabecular Metal-backed glenoids had a 25% rate of radiographic metal debris and osteolysis at a minimum 2-year follow-up in this series with one catastrophic failure. This implant should be used with caution, and patients followed closely.

摘要

背景

由于肩盂失败是解剖型全肩关节置换术(TSA)失败的主要原因之一,因此带有小梁金属背衬的肩盂假体变得流行起来。本研究报告了在初次解剖型 TSA 中使用小梁金属背衬的肩盂假体的患者的植入物存活率和临床结果。

方法

通过一位外科医生确定并回顾了接受过带有小梁金属背衬的肩盂假体的 TSA 患者的临床、影像学和患者报告的结果测量指标,随访时间至少为 2 年。

结果

在确定的 47 例患者中,有 36 例(77%)获得了影像学和临床随访。平均年龄为 66.36 岁(范围,50-85 岁),平均随访时间为 41 个月(范围,24-66 个月)。3 例患者出现溶骨性迹象,4 例患者有影像学证据表明有金属碎屑,1 例患者在跌倒后发生灾难性失败。在 47 例 TSA 中,有 5 例(11%)因肩胛下肌失败和疼痛而改为反向 TSA。疼痛视觉模拟评分平均改善了 4.4 分。在最终随访时,平均单项评估数值评分(Single Assessment Numeric Evaluation score)为 72.4;Penn 满意度评分为 7.5;Penn 评分为 70.35;美国肩肘外科医师协会评分(American Shoulder and Elbow Surgeons score)为 69.23。与没有影像学证据的患者相比,在有影像学证据显示有溶骨性病变或金属碎屑的 7 例患者中,其结果评分相似。

结论

在本系列研究中,至少 2 年的随访中有 25%的患者出现小梁金属背衬肩盂的影像学金属碎屑和溶骨性病变,且有 1 例灾难性失败。因此,应谨慎使用这种植入物,并密切随访患者。

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