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当前肩关节置换术围手术期成像概念。

Current peri-operative imaging concepts surrounding shoulder arthroplasty.

机构信息

Department of Orthopaedics, Duke University Hospital, 2301 Erwin Road, Durham, NC, 27710, USA.

Department of Radiology, Duke University Hospital, 2301 Erwin Road, Durham, NC, 27710, USA.

出版信息

Skeletal Radiol. 2019 Oct;48(10):1485-1497. doi: 10.1007/s00256-019-03183-3. Epub 2019 Feb 23.

Abstract

Glenohumeral osteoarthritis is a prevalent degenerative disease that can lead to excruciating pain and debility. End-stage osteoarthritis can be treated by both conservative and surgical interventions. Along with a comprehensive history and physical exam, pre-operative imaging with plain radiographs, computerized tomography, and magnetic resonance imaging plays an essential role in the decision-making process guiding whether the patient undergoes a shoulder hemiarthroplasty, anatomic total shoulder arthroplasty, or a reverse total shoulder arthroplasty. The most important pre-operative imaging factors are the integrity of the rotator cuff and presence of significant glenoid erosion. Imaging is also critical postoperatively, as signs of prosthetic loosening, rotator cuff failure (especially involving the subscapularis), periprosthetic fracture, and stress fractures are important entities to recognize. This article will review pertinent imaging findings related to the pre- and post-operative management of patients with glenohumeral osteoarthritis.

摘要

肩肱关节炎是一种常见的退行性疾病,可导致剧烈疼痛和虚弱。终末期骨关节炎可以通过保守和手术干预来治疗。除了全面的病史和体格检查外,术前影像学检查(包括 X 线平片、计算机断层扫描和磁共振成像)在指导患者进行肩关节半关节成形术、解剖全肩关节置换术或反式全肩关节置换术的决策过程中起着至关重要的作用。最重要的术前影像学因素是肩袖的完整性和明显的肩胛盂侵蚀。术后影像学也很关键,因为假体松动、肩袖失败(特别是涉及肩胛下肌)、假体周围骨折和应力性骨折的迹象是需要识别的重要问题。本文将回顾与肩肱关节炎患者术前和术后管理相关的影像学发现。

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