Galhoum Mohamed S, Elsheikh Ahmed A, Wood Amanda, Yin Qi, Frostick Simon P
Menoufia University, Egypt.
Mid Yorkshire Hospitals NHS Trust, UK.
J Shoulder Elb Arthroplast. 2022 Aug 24;6:24715492221118765. doi: 10.1177/24715492221118765. eCollection 2022.
Stemless shoulder arthroplasty was developed to restore the glenohumeral centre of rotation without violation of the humeral shaft. It allows the preservation of humeral bone stock. Complications related to stem malalignment and periprosthetic fractures can be avoided.
This is a prospective observational study that reports outcomes of 46 patients who received stemless shoulder arthroplasty "Comprehensive Nano implant ®." The series includes Group (A): 30 anatomic and one hemiarthroplasty. Group (B): 15 reverse stemless replacement. Functional outcomes were assessed by visual analog score (VAS), satisfaction, range motion, Constant score, and American Shoulder and Elbow Score (ASES).
The mean follow-up was 40.4 ± 12 months (range, 24 months to 60 months). Group (A): VAS and satisfaction improved by 5.3 and 67.5 points respectively. Constant score significantly improved from 28.5 ± 14.5 to 62.5 ± 23 P = <0.001. The radiological assessment showed the mean centre of rotation (COR) deviation was 2.8 ± 1.9 mm. 27% of patients have COR discrepancy of more than 4 mm. In Group (B), patients reported a significant improvement in VAS, Satisfaction, and ASES P = 0.002, 0.002, and 0.003, respectively.Complications include shoulder pain with progressive loss of movements, aseptic loosening early subscapularis rupture, glenohumeral dislocations, and humeral component migration.
Anatomic Stemless total shoulder arthroplasty offers acceptable results and improvement of overall functional outcomes.
无柄肩关节置换术旨在恢复肱骨头旋转中心，同时不侵犯肱骨干。它有助于保留肱骨骨量。可以避免与柄部排列不齐和假体周围骨折相关的并发症。
这是一项前瞻性观察性研究，报告了46例接受无柄肩关节置换术“Comprehensive Nano implant®”患者的结果。该系列包括A组：30例解剖型和1例半关节置换术。B组：15例反向无柄置换术。通过视觉模拟评分（VAS）、满意度、活动范围、Constant评分和美国肩肘评分（ASES）评估功能结果。
平均随访时间为40.4 ± 12个月（范围为24个月至60个月）。A组：VAS和满意度分别提高了5.3分和67.5分。Constant评分从28.5 ± 14.5显著提高到62.5 ± 23，P = <0.001。影像学评估显示平均旋转中心（COR）偏差为2.8 ± 1.9 mm。27%的患者COR差异超过4 mm。在B组中，患者报告VAS、满意度和ASES均有显著改善，P分别为0.002、0.002和0.003。并发症包括肩部疼痛伴活动逐渐丧失、无菌性松动、早期肩胛下肌破裂、肱骨头脱位和肱骨假体移位。
解剖型无柄全肩关节置换术提供了可接受的结果，并改善了整体功能结局。
