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肩部关节成形术最新进展:重点在于影像学

Update on Shoulder Arthroplasties with Emphasis on Imaging.

作者信息

Weaver Jennifer S, Omar Imran M, Chadwick Nicholson S, Shechtel Joanna L, Elifritz Jamie M, Shultz Christopher L, Taljanovic Mihra S

机构信息

Department of Radiology and Radiologic Sciences, Vanderbilt University Medical Center, 1161 21st Ave. S, MCN CCC-1118, Nashville, TN 37232, USA.

Department of Radiology, Northwestern Memorial Hospital, 676 N. Saint Clair Street, Suite 800, Chicago, IL 60611, USA.

出版信息

J Clin Med. 2023 Apr 18;12(8):2946. doi: 10.3390/jcm12082946.

Abstract

Shoulder pain and dysfunction may significantly impact quality of life. If conservative measures fail, advanced disease is frequently treated with shoulder arthroplasty, which is currently the third most common joint replacement surgery following the hip and knee. The main indications for shoulder arthroplasty include primary osteoarthritis, post-traumatic arthritis, inflammatory arthritis, osteonecrosis, proximal humeral fracture sequelae, severely dislocated proximal humeral fractures, and advanced rotator cuff disease. Several types of anatomic arthroplasties are available, such as humeral head resurfacing and hemiarthroplasties, as well as total anatomic arthroplasties. Reverse total shoulder arthroplasties, which reverse the normal ball-and-socket geometry of the shoulder, are also available. Each of these arthroplasty types has specific indications and unique complications in addition to general hardware-related or surgery-related complications. Imaging-including radiography, ultrasonography, computed tomography, magnetic resonance imaging, and, occasionally, nuclear medicine imaging-has a key role in the initial pre-operative evaluation for shoulder arthroplasty, as well as in post-surgical follow-up. This review paper aims to discuss important pre-operative imaging considerations, including rotator cuff evaluation, glenoid morphology, and glenoid version, as well as to review post-operative imaging of the various types of shoulder arthroplasties, to include normal post-operative appearances as well as imaging findings of complications.

摘要

肩部疼痛和功能障碍可能会对生活质量产生重大影响。如果保守治疗措施失败,晚期疾病通常采用肩关节置换术进行治疗,肩关节置换术目前是继髋关节和膝关节置换术后第三常见的关节置换手术。肩关节置换术的主要适应症包括原发性骨关节炎、创伤后关节炎、炎性关节炎、骨坏死、肱骨近端骨折后遗症、严重脱位的肱骨近端骨折以及晚期肩袖疾病。有几种类型的解剖型关节置换术可供选择,如肱骨头表面置换术和半关节置换术,以及全解剖型关节置换术。还有反向全肩关节置换术,它改变了肩部正常的球窝结构。除了一般的与硬件相关或手术相关的并发症外,每种类型的关节置换术都有特定的适应症和独特的并发症。影像学检查——包括X线摄影、超声检查、计算机断层扫描、磁共振成像,偶尔还有核医学成像——在肩关节置换术的术前初始评估以及术后随访中都起着关键作用。这篇综述文章旨在讨论重要的术前影像学考虑因素,包括肩袖评估、肩胛盂形态和肩胛盂倾斜度,以及回顾各种类型肩关节置换术的术后影像学表现,包括术后正常表现以及并发症的影像学表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b52/10143235/cda97bc5b283/jcm-12-02946-g001.jpg

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