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反向全进化肩系统(TESS)的长期结果。

Long-term results of the reverse Total Evolutive Shoulder System (TESS).

机构信息

Department of Orthopaedics and Trauma Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.

Department of Shoulder, Elbow, Hand and Foot Surgery, St. Josef Hospital, Bergstrasse 6-12, 42105, Wuppertal, Germany.

出版信息

Arch Orthop Trauma Surg. 2019 Aug;139(8):1039-1044. doi: 10.1007/s00402-019-03135-5. Epub 2019 Feb 6.

Abstract

INTRODUCTION

Latest trends in shoulder replacement aim at bone stock preservation. Long-term results of stemless anatomical total shoulder implants compare favourably with stemmed designs in terms of function and survivorship. The Total Evolutive Shoulder System (TESS) has been one of the first designs offering a stemless implant not only for anatomical but also for reverse total shoulder arthroplasty with optional short stem attachment in cases with poor bone quality. The aim of the present study was to evaluate long-term results of the reverse Total Evolutive Shoulder System (TESS).

MATERIALS AND METHODS

Between 2006 and 2009, 49 shoulders in 47 patients were replaced using the Biomet reverse Total Evolutive Shoulder System (TESS). 29 shoulders in 27 patients who were aged 72.4 ± 6.7 (53-88) years were available for review at a mean follow-up of 101.6 ± 24.6 (75-142) months.

RESULTS

The implant survival rate was 93.1% at 101 months (8.4 years). The overall revision rate of the TESS implant was 17.2%. No implant associated complications to the reverse corolla implant could be observed. All reverse corolla implants showed solid fixation at follow-up. Scapular notching was found in 72.3% of the shoulders. Clinical scores significantly improved at long-term follow-up (VAS from 7.5 ± 1.2 to 1.4 ± 1.5, p < 0.001; quick-DASH from 70.9 ± 12.0 to 28.9 ± 22.9, p < 0.001 and Constant score from 13.0 ± 3.7 to 60.5 ± 16.8, p < 0.001).

CONCLUSIONS

In terms of clinical scores, radiographic loosening, complication rates and implant survivorship the reverse Total Evolutive Shoulder System provides results comparable to those of conventional stemmed reverse shoulder arthroplasty.

摘要

简介

肩部置换的最新趋势旨在保留骨量。在功能和存活率方面,无柄解剖型全肩关节假体与带柄设计相比具有优势。Total Evolutive Shoulder System(TESS)是最早提供无柄植入物的设计之一,不仅适用于解剖型全肩关节置换,也适用于反向全肩关节置换,对于骨质量较差的病例,可选择短柄附着。本研究的目的是评估反向 Total Evolutive Shoulder System(TESS)的长期结果。

材料与方法

2006 年至 2009 年间,47 例患者的 49 肩接受了 Biomet 反向 Total Evolutive Shoulder System(TESS)置换。27 例患者的 29 肩(年龄 72.4±6.7 岁,53-88 岁)可进行回顾性分析,平均随访时间为 101.6±24.6 个月(75-142 个月)。

结果

101 个月(8.4 年)时,假体的生存率为 93.1%。TESS 假体的总翻修率为 17.2%。未观察到反向冠状假体与假体相关的并发症。所有反向冠状假体在随访时均显示出牢固的固定。肩胛切迹发生率为 72.3%。长期随访时临床评分显著改善(VAS 从 7.5±1.2 降至 1.4±1.5,p<0.001;快速-DASH 从 70.9±12.0 降至 28.9±22.9,p<0.001;Constant 评分从 13.0±3.7 升至 60.5±16.8,p<0.001)。

结论

在临床评分、放射学松动、并发症发生率和假体存活率方面,反向 Total Evolutive Shoulder System 的结果与传统带柄反向肩关节置换相当。

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