Malahias Michael-Alexander, Kostretzis Lazaros, Gkiatas Ioannis, Chronopoulos Efstathios, Brilakis Emmanouil, Antonogiannakis Emmanouil
3rd Orthopaedic Department, Hygeia Hospital, Athens, Greece.
The Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA.
Shoulder Elbow. 2021 Oct;13(6):627-641. doi: 10.1177/1758573220944168. Epub 2020 Jul 27.
Several articles have been published reporting on the clinical performance of a novel pegged, all-polyethylene glenoid component design which features a central peg, circumferentially fluted, interference-fit peg for tissue integration and three small peripheral pegs for cementing. However, no systematic review exists to this date.
The US National Library of Medicine (PubMed/MEDLINE), EMBASE, and the Cochrane Database of Systematic Reviews were queried for publications up to May 2020.
Overall, 13 articles were included for analysis (560 operated shoulders, range of mean follow-up: 2-6 years). The survival rate was 98.2% (550 out of 560 cases), while the rate of aseptic loosening was 0.2% (1 out of 560 cases). There were 139 cases (out of 399 reported; 34.1%) with peri-glenoid radiolucency, and 35 cases (out of 223 reported; 15.7%) of asymptomatic central peg osteolysis, with 1 of them undergoing revision.
There was fair quality of evidence to show that partially cemented all-polyethylene pegged bone-ingrowth glenoid components produce promising results, with a low revision rate in the short- to medium-term follow-up. Nevertheless, this analysis showed high rates of both radiolucency of the glenoid component and osteolysis around the central peg which raise concern for potential failure of this glenoid component in the long-term follow-up.
Systematic review, IV.
已有多篇文章报道了一种新型带栓钉的全聚乙烯关节盂组件设计的临床性能,该设计具有一个中心栓钉,圆周有凹槽,用于组织整合的干涉配合栓钉,以及三个用于骨水泥固定的小周边栓钉。然而,迄今为止尚无系统评价。
检索美国国立医学图书馆(PubMed/MEDLINE)、EMBASE和Cochrane系统评价数据库,获取截至2020年5月的出版物。
总体上,纳入13篇文章进行分析(560例手术肩关节,平均随访时间范围:2 - 6年)。生存率为98.2%(560例中的550例),无菌性松动率为0.2%(560例中的1例)。有139例(报告的399例中的;34.1%)出现关节盂周围透亮线,223例报告中有35例(15.7%)出现无症状的中心栓钉骨质溶解,其中1例接受了翻修手术。
有相当质量的证据表明,部分骨水泥固定的全聚乙烯带栓钉骨长入型关节盂组件产生了有前景的结果,在短期至中期随访中翻修率较低。然而,该分析显示关节盂组件透亮线和中心栓钉周围骨质溶解的发生率较高,这引发了对该关节盂组件在长期随访中潜在失败的担忧。
系统评价,IV级