Harrison Alicia K, Knudsen Michael L, Braman Jonathan P
Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA.
Curr Rev Musculoskelet Med. 2020 Aug;13(4):501-508. doi: 10.1007/s12178-020-09649-5.
The incidence of shoulder arthroplasty is increasing dramatically for primary arthroplasty but also for revision arthroplasty. Revision to reverse total shoulder arthroplasty is increasingly the salvage operation for failed primary arthroplasty. The purpose of this review is to explore the indications for and results of revision reverse total shoulder arthroplasty.
Despite relatively high complication and reoperation rates with revision shoulder replacement, revision of failed hemiarthroplasty or total shoulder arthroplasty to reverse total shoulder arthroplasty improves outcomes for many patients. A failed hemiarthroplasty or total shoulder arthroplasty is frequently disabling for the patient and because the surgical revision options are often limited only to reverse total shoulder arthroplasty, the potential improvement is often worth the higher surgical complication or reoperation rate. Due to the challenges inherent in revision arthroplasty, revision of primary arthroplasty to reverse total shoulder arthroplasty, outcomes are poorer than primary reverse total shoulder arthroplasty. Despite these limitations, patient postoperative pain and function do increase from preoperative levels making conversion of hemiarthroplasty or anatomic total shoulder to reverse total shoulder arthroplasty an important option for a challenging problem.
肩关节置换术的发生率在初次置换和翻修置换中均急剧上升。翻修为反式全肩关节置换术越来越成为初次置换失败后的挽救手术。本综述的目的是探讨翻修反式全肩关节置换术的适应证和结果。
尽管翻修肩关节置换术的并发症和再次手术率相对较高，但将失败的半肩关节置换术或全肩关节置换术翻修为反式全肩关节置换术可改善许多患者的预后。失败的半肩关节置换术或全肩关节置换术常常使患者致残，并且由于手术翻修选择通常仅限于反式全肩关节置换术，潜在的改善往往值得承受更高的手术并发症或再次手术率。由于翻修置换术固有的挑战，将初次置换术翻修为反式全肩关节置换术的结果比初次反式全肩关节置换术更差。尽管有这些局限性，但患者术后疼痛和功能较术前确实有所改善，这使得将半肩关节置换术或解剖型全肩关节置换术转换为反式全肩关节置换术成为解决这一难题的重要选择。
