van Ochten Johannes H M, van der Pluijm Marco, Pouw Martin, Felsch Quinten T M, Heesterbeek Petra, de Vos Maarten J
Center for Shoulder and Elbow Surgery, Städtisches Krankenhaus Nettetal, Nettetal, Germany.
Department of Orthopedics, Sint Maartenskliniek, Nijmegen, the Netherlands.
J Orthop. 2019 Mar 24;16(4):342-346. doi: 10.1016/j.jor.2019.03.007. eCollection 2019 Jul-Aug.
Purpose of this study was to evaluate the long - term survivorship and clinical and radiological results of a primary reverse total shoulder arthroplasty (RTSA) performed with uncemented stems.
From 2001 until 2006 61 primary uncemented RTSAs were implanted, which were included in a Kaplan-Meier survival analysis. Range of motion, functional scores and radiological follow - up was obtained. 27 patients were available for follow - up. Mean follow-up was 9.2 years (SD 2.4).
Mean cumulative survival was 82.4% (95% CI: 50.7-94.6%) of the total construct and 98.3% (CI: 88.8-98.8%) of the uncemented humeral stem after 12.5 years. Five revisions occurred (8.2%). Mean anteflexion improved from 69.3 to 111.9° (p < 0.0001), lateral elevation from 65.9 to 101.3° (p < 0.0001), Constant-Murley score from 39.1 to 66.9 (p < 0.0001), Simple Shoulder Test from 1.5 to 7.1 (p < 0.0001), and VAS-pain from 65.5 to 6.6 at final follow-up (p = 0.0003). Scapular notching was present in 94.1% of the patients.
The present study shows that the long-term clinical results of the primary Delta III RTSA seem very encouraging and survivorship of, in particular, its uncemented humeral stem is good.
本研究的目的是评估采用非骨水泥柄进行初次反向全肩关节置换术(RTSA)的长期生存率以及临床和影像学结果。
2001年至2006年期间,共植入61例初次非骨水泥RTSA,并纳入Kaplan-Meier生存分析。获得了活动范围、功能评分和影像学随访结果。27例患者可供随访。平均随访时间为9.2年(标准差2.4年)。
12.5年后,整个假体的平均累积生存率为82.4%(95%置信区间:50.7 - 94.6%),非骨水泥肱骨干的平均累积生存率为98.3%(置信区间:88.8 - 98.8%)。发生了5次翻修(8.2%)。末次随访时,平均前屈从69.3°提高到111.9°(p < 0.0001),外展从65.9°提高到101.3°(p < 0.0001),Constant-Murley评分从39.1提高到66.9(p < 0.0001),简单肩关节测试评分从1.5提高到7.1(p < 0.0001),视觉模拟评分疼痛从65.5降低到6.6(p = 0.0003)。94.1%的患者存在肩胛盂切迹。
本研究表明,初次Delta III RTSA的长期临床结果似乎非常令人鼓舞,特别是其非骨水泥肱骨干的生存率良好。