Sheth Ujash, Lee James Yj, Nam Diane, Henry Patrick
Sunnybrook Orthopaedic Upper Limb, Sunnybrook Health Sciences Centre, Division of Orthopaedic Surgery, University of Toronto, Toronto, Ontario, Canada.
Shoulder Elbow. 2022 Jun;14(3):238-248. doi: 10.1177/17585732211032922. Epub 2021 Aug 18.
The objective was to evaluate the short-term clinical and radiological outcomes following augmented anatomic total shoulder arthroplasty in patients with posterior glenoid deficiency.
An electronic search of EMBASE, MEDLINE, and PubMed identified studies reporting clinical and radiographic outcomes following augmented anatomic total shoulder arthroplasty among patients with posterior glenoid deficiency.
Nine studies including 312 shoulders underwent anatomic total shoulder arthroplasty using an augmented glenoid implant between 2015 and 2020. A statistically significant improvement in range of motion (ROM), visual analog scale (VAS), American Shoulder & Elbow Surgeons (ASES), Constant, University of California - Los Angeles and Simple Shoulder Test (SST) scores was demonstrated at mean follow-up of 37.1 months. Glenoid retroversion improved from 21.8° to 9.5°. At final follow-up, radiolucency was reported in 35.1% of shoulders. The 16° full-wedge augment led to higher and more severe radiographic lucency, while high peg perforation rates (44%) were observed among 5-mm augment stepped implants. The overall rate of complication was 2.6%. Rate of revision surgery was 1.9%.
Overall, early- to mid-term outcomes following augmented anatomic total shoulder arthroplasty for posterior glenoid deficiency demonstrate good to excellent overall clinical results. More radiographic and clinical failures were reported in larger full wedge (16°) augments and stepped augments (5 mm). Prospective studies examining mid- and long-term outcomes will help further elucidate safety and efficacy of these relatively new implants.
目的是评估后盂肱关节盂缺损患者行增强型解剖型全肩关节置换术后的短期临床和影像学结果。
通过对EMBASE、MEDLINE和PubMed进行电子检索，确定了报告后盂肱关节盂缺损患者行增强型解剖型全肩关节置换术后临床和影像学结果的研究。
9项研究共纳入312例肩关节，这些患者在2015年至2020年间接受了使用增强型盂肱关节盂植入物的解剖型全肩关节置换术。平均随访37.1个月时，活动范围（ROM）、视觉模拟评分（VAS）、美国肩肘外科医师协会（ASES）、Constant、加利福尼亚大学洛杉矶分校和简单肩关节测试（SST）评分均有统计学意义的显著改善。盂肱关节后倾从21.8°改善至9.5°。在末次随访时，35.1%的肩关节报告有透亮线。16°全楔形增强物导致更高且更严重的影像学透亮线，而在5毫米增强阶梯式植入物中观察到较高的钉穿孔率（44%）。总体并发症发生率为2.6%。翻修手术率为1.9%。
总体而言，后盂肱关节盂缺损患者行增强型解剖型全肩关节置换术的早期至中期结果显示出良好至优异的总体临床效果。在较大的全楔形（16°）增强物和阶梯式增强物（5毫米）中报告了更多的影像学和临床失败病例。检查中期和长期结果的前瞻性研究将有助于进一步阐明这些相对新型植入物的安全性和有效性。
