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反式肩关节置换中外展偏心球窝与同心球窝的临床和影像学结果。

Clinical and radiologic outcomes of eccentric glenosphere versus concentric glenosphere in reverse shoulder arthroplasty.

机构信息

Centre Orthopédique Santy, FIFA Medical Centre of Excellence, Groupe Ramsay-Générale de Santé, Hôpital Privé Jean Mermoz, Lyon, France.

Overlook Medical Center, Summit, NJ, USA.

出版信息

J Shoulder Elbow Surg. 2021 Aug;30(8):1899-1906. doi: 10.1016/j.jse.2020.10.032. Epub 2020 Dec 1.

Abstract

BACKGROUND

The use of an eccentric glenosphere (EG) has been proposed as a way to prevent scapular notching in reverse shoulder arthroplasty (RSA). The purpose of this study was to investigate whether the use of an EG decreases scapular notching compared with matched standard concentric glenosphere (CG) controls.

METHODS

A retrospective analysis was performed. This study included 49 RSAs with an EG and 49 paired RSAs with a CG with a minimum 60 months of both clinical and radiographic follow-up. Clinical and radiologic outcomes of the EG and CG groups were compared at inclusion and at the last follow-up using the paired Student t test for quantitative data and the χ test for qualitative data. Scapular notching was graded according to the Sirveaux classification. Statistical significance was set at P < .05.

RESULTS

Notching was observed 2.7 times (95% confidence interval, 1.0-6.8 times) more often in the CG group (P = .037). The difference in notching severity between the groups was not statistically relevant; however, there was a trend toward more severe notching in the CG group (P = .059). Compared with a CG, an EG did not increase the percentage of radiolucent lines around the screws (3% vs. 1.5%, P = .62), around the post (3% vs. 1.5%, P = .62), or below the baseplate (15% vs. 7.5%, P = .18).

CONCLUSION

EGs are associated with less notching than CGs. This finding confirms that RSA with an EG is an effective procedure without specific complications at a minimum follow-up of 5 years.

摘要

背景

在反肩关节置换术中,使用偏心肱骨头(EG)已被提议作为预防肩胛切迹的一种方法。本研究的目的是研究与匹配的标准同心肱骨头(CG)对照相比,使用 EG 是否会减少肩胛切迹。

方法

进行了回顾性分析。本研究包括 49 例使用 EG 的 RSA 和 49 例配对的使用 CG 的 RSA,均有至少 60 个月的临床和影像学随访。使用配对学生 t 检验对 EG 和 CG 组的临床和放射学结果进行比较,对定量数据进行比较,对定性数据进行卡方检验。根据 Sirveaux 分类对肩胛切迹进行分级。统计学意义设定为 P <.05。

结果

CG 组肩胛切迹的发生率高出 2.7 倍(95%置信区间,1.0-6.8 倍;P =.037)。两组间切迹严重程度的差异无统计学意义,但 CG 组的切迹严重程度有增加的趋势(P =.059)。与 CG 相比,EG 并不会增加螺钉周围的透亮线的百分比(3%比 1.5%,P =.62),也不会增加钉周围(3%比 1.5%,P =.62)或基底下方(15%比 7.5%,P =.18)的透亮线。

结论

EG 与 CG 相比,肩胛切迹发生率较低。这一发现证实,在至少 5 年的随访中,使用 EG 的 RSA 是一种有效的方法,没有特定的并发症。

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