Combes Damien, Lancigu Romain, Desbordes de Cepoy Patrick, Caporilli-Razza Filippo, Hubert Laurent, Rony Louis, Aubé Christophe
Radiology Department, Angers University Hospital, 4 rue Larrey, 49933, Angers, France.
Orthopedic and Trauma Unit, Angers University Hospital, 4 rue Larrey, 49933, Angers, France.
Insights Imaging. 2019 Oct 8;10(1):90. doi: 10.1186/s13244-019-0788-5.
Currently, an increasing number of patients benefit from shoulder prosthesis implantation. Radiologists are therefore more often confronted with imaging examinations involving shoulder arthroplasty, whether during a dedicated examination or incidentally. Standard radiography is the first-line imaging modality in the follow-up of these implants, before the possible use of cross-sectional imaging modalities (computed tomography and magnetic resonance imaging), ultrasound, or nuclear medicine examinations. Shoulder arthroplasties are divided into three categories: reverse shoulder arthroplasty, total shoulder arthroplasty, and partial shoulder joint replacement (including humeral hemiarthroplasty and humeral head resurfacing arthroplasty). Each of these prostheses can present complications, either shared by all types of arthroplasty or specific to each. Infection, periprosthetic fractures, humeral component loosening, heterotopic ossification, implant failure, and nerve injury can affect all types of prostheses. Instability, scapular notching, and acromial fractures can be identified after reverse shoulder arthroplasty implantation. Glenoid component loosening and rotator cuff tear are specific complications of total shoulder arthroplasty. Progressive wear of the native glenoid is the only specific complication observed in partial shoulder joint replacement. Knowledge of different types of shoulder prostheses and their complications' radiological signs is crucial for the radiologist to initiate prompt and adequate management.
目前,越来越多的患者受益于肩部假体植入。因此,放射科医生更频繁地面临涉及肩关节置换术的影像检查,无论是在专门检查期间还是偶然遇到。在可能使用断层成像模式(计算机断层扫描和磁共振成像)、超声或核医学检查之前,标准放射摄影是这些植入物随访中的一线成像方式。肩关节置换术分为三类:反式肩关节置换术、全肩关节置换术和部分肩关节置换术(包括肱骨头半关节置换术和肱骨头表面置换术)。这些假体中的每一种都可能出现并发症,有些是所有类型的关节置换术共有的,有些则是每种假体特有的。感染、假体周围骨折、肱骨组件松动、异位骨化、植入物失败和神经损伤会影响所有类型的假体。反式肩关节置换术植入后可发现不稳定、肩胛切迹和肩峰骨折。盂肱组件松动和肩袖撕裂是全肩关节置换术的特定并发症。天然盂的渐进性磨损是部分肩关节置换术中观察到的唯一特定并发症。了解不同类型的肩部假体及其并发症的放射学征象对于放射科医生及时启动适当的处理至关重要。