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无柄陶瓷头解剖型肩关节置换术治疗重度原发性骨关节炎(Walch B型关节盂)的良好疗效

Encouraging outcomes of stemless ceramic head anatomic shoulder arthroplasty in severe primary osteoarthritis (Walch type B glenoids).

作者信息

Edwards Gray Alexander, Coghlan Jennifer, Hughes Jeff, Wright Warwick, Dallalana Richard, Bell A/Prof Simon Nicolas

机构信息

Melbourne Shoulder and Elbow Centre, Melbourne, Australia.

Department of Surgery (School of Clinical Sciences at Monash Health), Monash University, Melbourne, Australia.

出版信息

Shoulder Elbow. 2023 Feb;15(1):28-36. doi: 10.1177/17585732211048120. Epub 2021 Oct 4.

Abstract

We report the radiological and functional outcomes at five years in patients with severe osteoarthritis of the glenohumeral joint and a Walch type B glenoid who have undergone stemless anatomic total shoulder replacement. A retrospective analysis of case notes, computed tomography scans and plain radiographs of patients undergoing anatomic total shoulder replacement for primary glenohumeral osteoarthritis were performed. Patients were grouped by the severity of their osteoarthritis using the modified Walch classification, glenoid retroversion and posterior humeral head subluxation. An evaluation was made using modern planning software. Functional outcomes were assessed using the American shoulder and elbow surgeons score, shoulder pain and disability index and visual analogue scale. Annual Lazarus scores were reviewed as regard to glenoid loosening. Thirty patients were reviewed at 5 years. Analysis of all patient-reported outcome measures demonstrated significant improvement at 5-year review, American shoulder and elbow surgeons ( = <0.0001), shoulder pain and disability index ( = 0.0001), visual analogue scale ( = 0.0001). Radiological associations between Walch scores and Lazarus scores were not statistically significant ( = 0.1251) at 5 years. There were no associations between features of glenohumeral osteoarthritis and patient-reported outcome measures. The severity of osteoarthritis did not show any association with glenoid component survivorship or with patient-reported outcome measures at 5 years review. IV.

摘要

我们报告了接受无柄解剖型全肩关节置换术的盂肱关节严重骨关节炎且肩胛盂为Walch B型的患者在五年时的放射学和功能结果。对因原发性盂肱关节骨关节炎接受解剖型全肩关节置换术的患者的病历、计算机断层扫描和X线平片进行了回顾性分析。根据改良的Walch分类、肩胛盂后倾和肱骨头后下方半脱位,将患者按骨关节炎的严重程度分组。使用现代规划软件进行评估。功能结果采用美国肩肘外科医师评分、肩部疼痛和功能障碍指数以及视觉模拟量表进行评估。就肩胛盂松动情况对年度拉撒路评分进行了回顾。30例患者在5年时接受了复查。对所有患者报告的结局指标进行分析表明,在5年复查时,美国肩肘外科医师评分(P = <0.0001)、肩部疼痛和功能障碍指数(P = 0.0001)、视觉模拟量表(P = 0.0001)均有显著改善。5年时,Walch评分与拉撒路评分之间的放射学相关性无统计学意义(P = 0.1251)。盂肱关节骨关节炎的特征与患者报告的结局指标之间无相关性。在5年复查时,骨关节炎的严重程度与肩胛盂假体生存率或患者报告的结局指标均无关联。四、

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Characterization of the Walch B3 glenoid in primary osteoarthritis.原发性骨关节炎中Walch B3型肩胛盂的特征分析
J Shoulder Elbow Surg. 2017 May;26(5):909-914. doi: 10.1016/j.jse.2016.10.003. Epub 2017 Jan 11.

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