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半髋关节成形术和解剖型全肩关节成形术翻修为反式全肩关节成形术。

Revision of failed hemiarthroplasty and anatomic total shoulder arthroplasty to reverse total shoulder arthroplasty.

机构信息

Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX, USA.

Department of Orthopaedic Surgery, Rothman Orthopaedics-Thomas Jefferson University, Philadelphia, PA, USA.

出版信息

J Shoulder Elbow Surg. 2019 Jun;28(6):1074-1081. doi: 10.1016/j.jse.2018.10.026. Epub 2019 Feb 1.

Abstract

BACKGROUND

The impending burden of revision shoulder arthroplasty has increased interest in outcomes of revision procedures. Revision of failed anatomic arthroplasty to reverse total shoulder arthroplasty has shown promise alongside concerning complication rates.

METHODS

Patients who underwent revision shoulder arthroplasty during a 7-year period at a tertiary care health system were identified. Presurgical and operative data were analyzed for 110 patients who met inclusion and exclusion criteria. Patients were contacted at a mean follow-up of 57 ± 26 months (range, 23-113 months) from revision surgery for functional outcomes scores, reoperations, and implant survival.

RESULTS

Implant survival was 92% at 2 years and 74% at 5 years. Mean American Shoulder and Elbow Surgeons score, Single Assessment Numerical Evaluation score, and visual analog scale pain scores were 63 ± 24 (range, 5-97), 60 ± 25 (range, 0-100), and 2.9 ± 2.9 (range, 0-10), respectively. Seventy percent of patients were "very satisfied" or "satisfied with their outcome. Complications occurred in 18 patients (20%), and 10 patients (11%) underwent reoperation.

CONCLUSIONS

Modest patient results and satisfaction can be achieved with revision of a failed anatomic arthroplasty to a reverse total shoulder arthroplasty. As is typical of revision surgery, complications are common and can compromise results. Further study is needed to identify factors that may contribute to successful outcomes.

摘要

背景

翻修肩关节炎的迫在眉睫的负担增加了对翻修手术结果的兴趣。在三级保健系统中,对失败的解剖型关节置换进行翻修以逆转全肩关节置换已显示出前景,同时也存在令人担忧的并发症发生率。

方法

在三级保健系统中,确定了在 7 年期间接受翻修肩关节炎手术的患者。对符合纳入和排除标准的 110 名患者的术前和手术数据进行了分析。在翻修手术后平均随访 57±26 个月(范围,23-113 个月)时,对患者进行了功能结果评分、再次手术和植入物存活率的联系。

结果

2 年时植入物存活率为 92%,5 年时为 74%。平均美国肩肘外科评分、单项评估数值评分和视觉模拟评分疼痛分别为 63±24(范围,5-97)、60±25(范围,0-100)和 2.9±2.9(范围,0-10)。70%的患者“非常满意”或“对自己的结果满意”。18 名患者(20%)发生并发症,10 名患者(11%)接受再次手术。

结论

对失败的解剖型关节置换进行翻修以逆转全肩关节置换术,可以获得适度的患者结果和满意度。与翻修手术一样,并发症很常见,可能会影响结果。需要进一步研究以确定可能有助于取得成功结果的因素。

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