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反式肩关节置换术中偏心肱骨头的中期临床和放射学结果。

Midterm clinical and radiologic results of reverse shoulder arthroplasty with an eccentric glenosphere.

机构信息

Ramsay Générale de Santé, Hôpital privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France.

Overlook Medical Center, Summit, NJ, USA.

出版信息

J Shoulder Elbow Surg. 2020 May;29(5):976-981. doi: 10.1016/j.jse.2019.09.044. Epub 2020 Jan 3.

Abstract

BACKGROUND

An eccentric glenosphere (EG) has been proposed as a way of preventing scapular notching after reverse shoulder arthroplasty (RSA). Our aim was to report the midterm clinical and radiographic results of EG after RSA. A number of the patients described here were included in a previous study with short-term follow-up. The current retrospective study gave us the opportunity to follow many of these patients for a longer period of time.

METHODS

A retrospective analysis of prospectively collected data was conducted. Statistical significance was set at P < .001. Forty-nine RSAs with an EG and at least 60 months of follow-up were included. Range of motion (ROM), Constant scores (CSs), and Subjective Shoulder Value (SSV) were assessed. Scapular notching was graded according to the Sirveaux classification.

RESULTS

At the last follow-up, the mean improvement in active elevation (ROM) was 46° and the mean CS increased by nearly 31 points (both groups P < .001). The final SSV was 70%. Twenty-one patients (43%) had scapular notching, but in two-thirds of patients it was low-grade.

CONCLUSION

The use of an EG provided excellent clinical outcomes that persisted with midterm follow-up. The rate of notching was lower than in other studies with EGs, but further studies are required to confirm this. An EG was safe and there were no issues with baseplate loosening or failure.

摘要

背景

偏心肱骨头(EG)被提议作为预防反肩关节置换术(RSA)后肩胛切迹的一种方法。我们的目的是报告 RSA 后 EG 的中期临床和影像学结果。这里描述的许多患者都包含在以前具有短期随访的研究中。目前的回顾性研究使我们有机会对这些患者中的许多人进行更长时间的随访。

方法

对前瞻性收集的数据进行回顾性分析。统计学意义设定为 P <.001。包括 49 例 RSA 和至少 60 个月的随访的 EG。评估了活动范围(ROM)、Constant 评分(CS)和主观肩部值(SSV)。根据 Sirveaux 分类对肩胛切迹进行分级。

结果

最后一次随访时,主动抬高(ROM)的平均改善为 46°,平均 CS 增加了近 31 分(两组 P <.001)。最终 SSV 为 70%。21 名患者(43%)有肩胛切迹,但三分之二的患者为低度。

结论

使用 EG 提供了出色的临床结果,并且在中期随访中持续存在。切迹率低于其他使用 EG 的研究,但需要进一步研究来证实这一点。EG 是安全的,没有底板松动或失败的问题。

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