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部分肩关节表面置换术中植入物定位与功能结果的相关性

Correlation Between Implant Positioning and Functional Outcomes in Partial Shoulder Resurfacing.

作者信息

Luz Gilberto Daniel, Cavalcanti Amanda S, Ferreira Júlio, Godoy Eduardo, Amaral Marcus Vinicius Galvão, Motta Filho Geraldo da R

机构信息

Centro de Cirurgia do Ombro e Cotovelo, Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ, Brasil.

Divisão de Pesquisa, Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2022 Mar 11;57(3):480-487. doi: 10.1055/s-0041-1729589. eCollection 2022 Jun.

DOI:10.1055/s-0041-1729589
PMID:35785124
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9246527/
Abstract

The present study aimed to correlate functional outcomes and implant positioning in a case series of partial shoulder resurfacing arthroplasties.  A total of 25 patients were assessed for range of motion, functional outcome per the University of California at Los Angeles (UCLA) score and radiographic findings. Pre- and postoperative data were compared. In addition, patients were grouped according to the cervical-diaphyseal angle (CDA) determined by an anteroposterior radiography and to the retroversion angle (RVA) determined by an axillary radiography. A CDA from 130° to 140° and a RVA from 20° to 40° consisted in ideal positioning (anatomical standard). Data were analyzed using the Wilcoxon signed-rank test, analysis of variance (ANOVA) followed by the Kruskal-Wallis test or the Mann-Whitney test as appropriate.  The mean follow-up time was 48.3 months (12 to 67 months). The postoperative functional score (31.5) was higher than the preoperative score (15.5) (  < 0.001). In 6 patients, the implant was in anatomical positioning, while implant positioning was considered "nonstandard" in 19 subjects. Seven patients had a CDA < 130°, and 14 patients had a CDA ranging from 130° to 140°; in addition, the CDA was > 140° in 4 subjects. The RVA was up to 20° in 15 patients and ranged from 20° to 40° in 10 subjects. Using these criteria to group patients, the postoperative clinical-functional parameters were not statistically different from the preoperative findings (  > 0.05).  Partial shoulder resurfacing results in significant postoperative functional recovery in patients with degenerative joint diseases. However, implant positioning assessed by CDA and RVA does not correlate with clinical-functional outcomes and, therefore, it is an inaccurate indicator of surgical success. Level of Evidence IV; Case Series.

摘要

本研究旨在关联部分肩关节表面置换术病例系列中的功能结果与植入物位置。共评估了25例患者的活动范围、根据加州大学洛杉矶分校（UCLA）评分得出的功能结果以及影像学表现。对术前和术后数据进行了比较。此外，根据前后位X线片确定的颈椎骨干角（CDA）以及腋位X线片确定的后倾角（RVA）对患者进行分组。CDA为130°至140°且RVA为20°至40°构成理想位置（解剖学标准）。使用Wilcoxon符号秩检验、方差分析（ANOVA），随后根据情况进行Kruskal-Wallis检验或Mann-Whitney检验对数据进行分析。平均随访时间为48.3个月（12至67个月）。术后功能评分（31.5）高于术前评分（15.5）（<0.001）。6例患者的植入物处于解剖学位置，而19例患者的植入物位置被认为“不标准”。7例患者的CDA<130°，14例患者的CDA在130°至140°之间；此外，4例患者的CDA>140°。15例患者的RVA高达20°，10例患者的RVA在20°至40°之间。使用这些标准对患者进行分组，术后临床功能参数与术前结果无统计学差异（>0.05）。部分肩关节表面置换术可使退行性关节疾病患者术后功能显著恢复。然而，通过CDA和RVA评估的植入物位置与临床功能结果无关，因此，它是手术成功与否的不准确指标。证据等级IV；病例系列。

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本文引用的文献

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