MacAskill Micah L, Thomas Rachel J, Barnes Leslie A
Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
Department of Orthopaedic Surgery and Sports Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania.
J Shoulder Elb Arthroplast. 2020 Aug 27;4:2471549220949147. doi: 10.1177/2471549220949147. eCollection 2020.
Reverse shoulder arthroplasty is a useful procedure with broadening applications, but it has the best outcomes when used for rotator cuff tear arthropathy. However, this procedure is not without complications. While scapular notching and aseptic loosening are more common complications that have been extensively studied in the literature, dissociation of the glenoid component and incomplete glenosphere seating has not received much attention. Specifically, little research has explored appropriate management of incomplete seating of the glenosphere component, and no gold standard for treatment of this complication has emerged. In the case described here, an elderly patient with an incompletely seated glenosphere component post-operatively opted to pursue conservative management in order to avoid revision surgery if possible. The partially engaged, superiorly directed components in this case exhibited spontaneous complete and symmetric seating of the glenosphere between six and twelve months post-operatively, indicating that conservative management of this complication in low-demand patients may be a viable option to avoid the risks associated with revision surgery. Further research should be pursued to explore what patient and prosthesis design factors may be suited to observation with serial radiographs when incomplete seating of the glenosphere component occurs.
反肩关节置换术是一种应用日益广泛的有效手术，但用于肩袖撕裂性关节病时效果最佳。然而，该手术并非没有并发症。虽然肩胛切迹和无菌性松动是文献中已广泛研究的较常见并发症，但关节盂组件分离和关节盂球窝不完全就位并未受到太多关注。具体而言，很少有研究探讨关节盂球窝组件不完全就位的适当处理方法，且尚未出现治疗该并发症的金标准。在此所述病例中，一名老年患者术后关节盂球窝组件就位不完全，为尽可能避免翻修手术，选择采取保守治疗。该病例中部分嵌入、向上指向的组件在术后6至12个月内关节盂球窝自发完全且对称就位，表明对需求较低的患者的这种并发症采取保守治疗可能是避免翻修手术相关风险的可行选择。应进一步开展研究，以探索当关节盂球窝组件不完全就位时，哪些患者和假体设计因素可能适合通过系列X线片进行观察。
