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无柄反向全肩关节置换术:短期和中期结果的系统评价。

Stemless reverse total shoulder arthroplasty: a systematic review of short- and mid-term results.

作者信息

Liu Eva Y, Kord Dorsa, Yee Nicholas J, Horner Nolan S, Al Mana Latifah, Leroux Timothy, Alolabi Bashar, Khan Moin

机构信息

Faculty of Health Sciences, McMaster University, Hamilton, Canada.

Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.

出版信息

Shoulder Elbow. 2021 Oct;13(5):482-491. doi: 10.1177/17585732211013356. Epub 2021 May 20.

Abstract

INTRODUCTION

Stemless reverse total shoulder arthroplasty is used to treat rotator cuff deficient arthropathies, rheumatoid arthritis, and osteoarthritis. It has several advantages over the stemmed implant including preservation of bone stock, reduced surgical time, and easier revision.

METHODS

A systematic search was conducted in MEDLINE, EMBASE, PubMed, and CENTRAL to retrieve all relevant studies evaluating stemless reverse total shoulder arthroplasty.

RESULTS

The literature search identified 1993 studies out of which 7 studies were included in this review; 324 patients underwent stemless reverse total shoulder arthroplasty with a weighted mean age of 74.1 (SD = 8.6, range = 38 to 93) years and a weighted mean follow-up time of 44 (SD = 6.6, range = 3 to 95) months. The included studies reported significant improvements in range of motion and functional scores comparable to stemmed reverse total shoulder arthroplasty. The weight mean flexion and abduction was (135 ± 12)° and (131 ± 12)° post-operatively, respectively. The weighted mean constant score increased from (26.7 ± 5.2) Patients (pts) to (63.0 ± 8.0) pts post-operatively. Overall complication and revision rate were 12.3% and 5.2%.

CONCLUSION

Early and mid-term results indicate stemless reverse total shoulder arthroplasty has similar clinical outcomes to stemmed reverse total shoulder arthroplasty. There was no radiological evidence of humeral loosening at the latest follow-up.

摘要

引言

无柄反向全肩关节置换术用于治疗肩袖损伤性关节病、类风湿性关节炎和骨关节炎。与有柄植入物相比,它具有几个优点,包括保留骨量、减少手术时间和更容易翻修。

方法

在MEDLINE、EMBASE、PubMed和CENTRAL中进行系统检索,以检索所有评估无柄反向全肩关节置换术的相关研究。

结果

文献检索共识别出1993项研究,其中7项研究纳入本综述;324例患者接受了无柄反向全肩关节置换术,加权平均年龄为74.1岁(标准差=8.6,范围=38至93岁),加权平均随访时间为44个月(标准差=6.6,范围=3至95个月)。纳入的研究报告称,与有柄反向全肩关节置换术相比,无柄反向全肩关节置换术在活动范围和功能评分方面有显著改善。术后加权平均屈曲和外展分别为(135±12)°和(131±12)°。加权平均常数评分从术前的(26.7±5.2)分提高到术后的(63.0±8.0)分。总体并发症和翻修率分别为12.3%和5.2%。

结论

早期和中期结果表明,无柄反向全肩关节置换术与有柄反向全肩关节置换术具有相似的临床疗效。在最新随访中,没有肱骨松动的影像学证据。

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