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采用 Arthrex Eclipse 无柄肱骨干假体行全肩关节置换术的临床和影像学结果:至少 2 年随访。

Clinical and radiologic outcomes following total shoulder arthroplasty using Arthrex Eclipse stemless humeral component with minimum 2 years' follow-up.

机构信息

Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter Hospital, Exeter, UK.

Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter Hospital, Exeter, UK.

出版信息

J Shoulder Elbow Surg. 2018 Dec;27(12):2191-2197. doi: 10.1016/j.jse.2018.05.039. Epub 2018 Aug 6.

DOI:10.1016/j.jse.2018.05.039
PMID:30093232
Abstract

BACKGROUND

Stemless humeral components benefit from less morbidity, better reproduction of the humeral anatomy, ease of revision, and fewer stem-related complications. Encouraging results are available up to 9 years after surgery from the designer's series. This is an independent study of 100 consecutive Eclipse stemless prostheses for osteoarthritis with a minimum 2-year follow-up (range, 2-6 years).

METHODS

We included only total shoulder arthroplasties performed for osteoarthritis. The primary outcome was the Oxford Shoulder Score (OSS) after 2 years. Secondary outcome measures were change in shoulder range of movement and radiographic analysis of prosthesis size and position.

RESULTS

The mean OSS at 2 years was 38 of 48, with a mean improvement of +19 points (range, +17 to +22 points; P < .001). There was no significant deterioration in OSS after 3 or 4 years' follow-up. Statistically significant improvement was seen in arm elevation and external rotation (P < .001). There were 5 reoperations-1 for impingement of the biceps stump and 4 revisions to reverse arthroplasty for cuff failure. Of the prostheses, 92% were sized within 2 mm of the anatomic head size, and in 76% of prostheses, the center of rotation was within 3 mm of the native anatomy. An incomplete radiolucent line was present in zone B (around the cage screw) in a single patient at 2 years following surgery. There were no cases of loosening or infection.

CONCLUSION

The functional and radiographic outcomes of Eclipse total shoulder replacement are excellent. We were able to accurately reproduce the native anatomy in the majority of cases, with no implant loosening, at 2 to 6 years' follow-up.

摘要

背景

无柄肱骨头假体具有发病率较低、更好地恢复肱骨头解剖结构、易于翻修以及较少与假体相关并发症等优点。手术设计系列的研究结果显示,手术后 9 年内效果令人鼓舞。本研究为 100 例连续接受 Eclipse 无柄假体治疗骨关节炎患者的独立研究,随访时间至少 2 年(2-6 年)。

方法

仅纳入因骨关节炎行全肩关节置换术的患者。主要观察指标为术后 2 年的牛津肩评分(OSS)。次要观察指标为肩关节活动范围的变化和假体大小及位置的影像学分析。

结果

术后 2 年时平均 OSS 为 38 分(48 分制),平均改善+19 分(+17 分至+22 分;P<0.001)。3 年和 4 年随访时 OSS 无明显恶化。肩关节外展和外旋明显改善(P<0.001)。有 5 例患者行再次手术,其中 1 例因二头肌残端撞击行撞击征松解术,4 例行因肩袖失败行反肩关节置换术。假体中 92%与解剖头大小相差 2 mm 以内,76%的假体旋转中心与正常解剖结构相差 3 mm 以内。术后 2 年,有 1 例患者在 B 区(笼状螺钉周围)出现不完全透亮线,但无假体松动或感染病例。

结论

Eclipse 全肩关节置换术的功能和影像学结果优良。我们在 2 至 6 年随访时,大多数病例能准确地恢复正常解剖结构,且无假体松动。

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