Bernal N, Paccot D, Franz P, Calvo A, Toro F, Reinares F
Departamento de Traumatología, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
Departamento de Traumatología, Hospital Clínico Mutual de Seguridad CChC, Santiago, Chile.
Acta Ortop Mex. 2021 May-Jun;35(3):245-251.
Compare functional and radiological outcomes of three different designs of reverse shoulder arthroplasty according to distalization and lateralization shoulder angle, in heterogenic diagnostics (fracture, cuff arthropathy, fracture sequela and osteoarthritis).
Prospective cohort of 33 patients of reverse shoulder arthroplasty (RSA) between December 2014 and July 2017 with a minimum one year of follow-up. We defined three groups, G: 10 patients with Grammont (155o, Medialized Glena), B: 9 patients with Bio-RSA (155º, lateralized bone glena) and A: 14 patients with Arrow (135o, lateralized metallic glena). We analyze demographic, clinical, functional and radiological outcomes (lateralization shoulder angle (LSA) and distalization shoulder angle (DSA)). For the statistical analysis, ANOVA, T-tests and linear regression tests were used, with a statistical significance of 5%.
The LSA was significantly higher in group A (98o A, 79o G, 80o B) (p < 0.05). In DSA, group B was significantly higher than A (52o B, 39o A) (p < 0.05) and not significant to G (48o G) (p = 0.06). There was no correlation of LSA and DSA with external rotation (p = 0.51) and active elevation (p = 0.41), respectively. There was no significant clinical (anterior elevation, external rotation, internal rotation) and functional outcomes (adjusted Constant score and subjective shoulder evaluation) differences between the different RSA models (p > 0.05).
The LSA was higher in the Arrow and the DSA was higher in Bio-RSA. We did not find Clinical - Radiological correlation in this heterogeneous series of patients.
在异质性诊断(骨折、肩袖关节病、骨折后遗症和骨关节炎)中,根据肩关节的远侧化和外侧化角度,比较三种不同设计的反肩关节置换术的功能和影像学结果。
对2014年12月至2017年7月间接受反肩关节置换术(RSA)的33例患者进行前瞻性队列研究,随访时间至少1年。我们定义了三组,G组:10例接受Grammont型(155°,内侧化肩胛盂)的患者,B组:9例接受Bio-RSA型(155°,外侧化骨肩胛盂)的患者,A组:14例接受Arrow型(135°,外侧化金属肩胛盂)的患者。我们分析了人口统计学、临床、功能和影像学结果(肩关节外侧化角度(LSA)和远侧化角度(DSA))。对于统计分析,使用了方差分析、t检验和线性回归检验,统计学显著性水平为5%。
A组的LSA显著更高(A组98°,G组79°,B组80°)(p<0.05)。在DSA方面,B组显著高于A组(B组52°,A组39°)(p<0.05),与G组(48°)无显著差异(p=0.06)。LSA和DSA分别与外旋(p=0.51)和主动抬高(p=0.41)均无相关性。不同RSA模型之间在临床(前屈、外旋、内旋)和功能结果(调整后的Constant评分和主观肩关节评估)方面无显著差异(p>0.05)。
Arrow型的LSA更高,Bio-RSA型的DSA更高。在这组异质性患者中,我们未发现临床与影像学之间的相关性。