Franceschetti Edoardo, Gregori Pietro, Giurazza Giancarlo, Papalia Giuseppe, Caraffa Auro, Papalia Rocco
Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Rome, Italy.
Department of Orthopaedic and Trauma Surgery, Perugia hospital, Perugia, Italy.
J Shoulder Elb Arthroplast. 2023 Jan 22;7:24715492231152143. doi: 10.1177/24715492231152143. eCollection 2023.
The appropriate surgical treatment option for young and active patients undergoing shoulder arthroplasty for arthritis remains questionable. Pyrolitic carbon (pyrocarbon) has been shown to improve implant longevity and decrease wear when in contact with cartilage or bone. The present systematic review aimed to evaluate clinical and radiological outcomes as well as the survivorship of pyrocarbon shoulder implants.
The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. A systematic search was performed using the MEDLINE, EMBASE and Cochrane Library databases. All the studies dealing with the use of pyrolitic shoulder implants were pooled, data of interest were extracted and statistically analyzed through meta-analysis.
A total of 9 studies were included for a total of 477 shoulders treated. The overall mean rate of survival of the implants was 93.4 ± 5.8% and 80% ± 26.5% at 2 years and final follow up, respectively, while resulting 82.4% ± 22.1% and 92.3% ± 3.5% for PISA (pyrocarbon interposition shoulder arthroplasty) and hemi-arthroplasty/hemi-resurfacing, respectively.
Pyrolitic carbon shoulder implants showed good survivorship and clinical outcomes at an early to early-midterm follow-up. More studies and better-designed trials are needed in order to enrich the evidence on long-term outcomes and comparison with other shoulder replacement options for young and active patients.
IV.
对于因关节炎接受肩关节置换术的年轻活跃患者，合适的手术治疗方案仍存在疑问。热解碳已被证明在与软骨或骨接触时可提高植入物的使用寿命并减少磨损。本系统评价旨在评估热解碳肩关节植入物的临床和放射学结果以及生存率。
遵循PRISMA（系统评价和Meta分析的首选报告项目）指南。使用MEDLINE、EMBASE和Cochrane图书馆数据库进行系统检索。汇总所有涉及使用热解肩关节植入物的研究，提取感兴趣的数据并通过Meta分析进行统计分析。
共纳入9项研究，涉及477个肩关节。植入物的总体平均生存率在2年和最终随访时分别为93.4±5.8%和80%±26.5%，而PISA（热解碳置入式肩关节置换术）和半关节置换术/半表面置换术的生存率分别为82.4%±22.1%和92.3%±3.5%。
在早期至中期随访中，热解碳肩关节植入物显示出良好的生存率和临床结果。需要更多的研究和设计更好的试验，以丰富关于长期结果的证据，并与年轻活跃患者的其他肩关节置换选择进行比较。
IV级。
