Tross Anna-K, Lädermann Alexandre, Wittmann Thomas, Schnetzke Marc, Nolte Philip-C, Collin Philippe, Raiss Patric
Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany.
Division of Orthopaedics and Trauma Surgery, La Tour Hospital Meyrin, Avenue Jacob-Daniel Maillard 31217 Meyrin, Switzerland.
J Clin Med. 2020 Oct 20;9(10):3362. doi: 10.3390/jcm9103362.
The radiological phenomenon of subsidence following the implantation of uncemented short-stem reverse prostheses (USSP) has not yet been described. The purpose of this study was to describe the rate and potential risk factors for subsidence. We hypothesized that subsidence may be a frequent finding and that a subsidence of >5 mm (mm) is associated with an inferior clinical outcome.
A total of 139 patients with an average age of 73 ± 9 years were included. The clinical and radiological outcome was evaluated at a minimum follow-up (FU) of 12 months.
No humeral component loosening was present at a mean FU of 18 (range, 12-51) months. Mean Constant Score (CS) and Subjective Shoulder Value (SSV) improved significantly from 34.3 ± 18.0 points and 37.0 ± 19.5% preoperatively to 72.2 ± 13.4 points and 80.3 ± 16.5% at final FU ( < 0.001). The average subsidence of the USSP was 1.4 ± 3.7 mm. Subsidence of >5 mm was present in 15 patients (11%). No association between a subsidence >5 mm and CS or SSV was found ( = 0.456, = 0.527). However, a subsidence of >5 mm resulted in lower strength at final FU ( = 0.022). Complications occurred in six cases (4.2%), and the revision rate was 3.5% (five cases).
Although subsidence of USSP is a frequent radiographic finding it is not associated with loosening of the component or a decrease in the clinical outcome at short term FU.
Level 4, retrospective study.
非骨水泥型短柄反向假体(USSP)植入后出现下沉的放射学现象尚未见报道。本研究的目的是描述下沉的发生率及潜在危险因素。我们假设下沉可能是常见现象,且下沉超过5毫米(mm)与较差的临床结局相关。
共纳入139例平均年龄为73±9岁的患者。在至少12个月的随访(FU)时评估临床和放射学结局。
平均随访18(范围12 - 51)个月时未出现肱骨假体松动。平均Constant评分(CS)和主观肩关节评分(SSV)从术前的34.3±18.0分和37.0±19.5%显著提高至最终随访时的72.2±13.4分和80.3±16.5%(<0.001)。USSP的平均下沉为1.4±3.7毫米。15例患者(11%)下沉超过5毫米。未发现下沉超过5毫米与CS或SSV之间存在关联(=0.456,=0.527)。然而,下沉超过5毫米导致最终随访时力量降低(=0.022)。6例(4.2%)发生并发症,翻修率为3.5%(5例)。
尽管USSP下沉是常见的影像学表现,但在短期随访时它与假体松动或临床结局下降无关。
4级,回顾性研究。