Reuther Falk, Irlenbusch Ulrich, Kääb Max J, Kohut Georges
Department of Trauma Surgery and Orthopaedics, DRK Kliniken Berlin Koepenick, Salvador-Allende-Str. 2-8, 12559 Berlin, Germany.
Clinic for Orthopaedics and Trauma Surgery, Erfurt Sports Clinic, Am Urbicher Kreuz 7, 99099 Erfurt, Germany.
J Clin Med. 2022 Feb 4;11(3):834. doi: 10.3390/jcm11030834.
The purpose of this study is to evaluate the mid-term clinical results of an ongoing case series on conversion reverse shoulder arthroplasty (RSA) with a modular prosthesis system. We included 17 elderly patients revised for failed hemiarthroplasty after proximal humeral fracture, of which 13 were converted using a modular reverse shoulder prosthesis. Four could not be converted due to overstuffing. For the conversion RSA, we determined the Constant score, American Shoulder and Elbow Surgeons Shoulder Score, visual analogue scale for pain and satisfaction, and range of motion preoperatively, at one year, and at the last follow-up. All measured clinical outcomes improved significantly at both follow-up time points ( < 0.05). The mean duration of surgery was 118.4 min (range: 80.0 to 140.0 min). We observed complications in three patients; these included one late infection and two aseptic stem loosenings. Modular shoulder arthroplasty is a suitable procedure for conversion RSA in elderly patients. All measured postoperative clinical outcomes improved significantly, the complication rate was acceptable, and no prosthesis-related complications occurred. Conversion RSA, although not feasible in every case, is a viable treatment option in the elderly, which can provide successful mid-term results.
本研究的目的是评估正在进行的一组采用模块化假体系统进行翻修性反肩关节置换术(RSA)病例系列的中期临床结果。我们纳入了17例因肱骨近端骨折后半关节置换失败而接受翻修的老年患者,其中13例采用模块化反肩关节假体进行了翻修。4例因填充过多而无法进行翻修。对于翻修性RSA,我们在术前、术后1年和最后一次随访时测定了Constant评分、美国肩肘外科医师协会肩关节评分、疼痛和满意度视觉模拟量表以及活动范围。在两个随访时间点,所有测量的临床结果均有显著改善(<0.05)。平均手术时间为118.4分钟(范围:80.0至140.0分钟)。我们观察到3例患者出现并发症;其中包括1例晚期感染和2例无菌性假体柄松动。模块化肩关节置换术是老年患者翻修性RSA的合适手术方式。所有测量的术后临床结果均有显著改善,并发症发生率可接受,且未发生与假体相关的并发症。翻修性RSA虽然并非在每种情况下都可行,但对于老年患者是一种可行的治疗选择,可提供成功的中期结果。