Cooper Kendall S, Powell Garret M, Baffour Francis I, Johnson Matthew P, Frick Matthew A
Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Division of Hospital and Emergency Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Emerg Radiol. 2023 Aug;30(4):475-483. doi: 10.1007/s10140-023-02157-2. Epub 2023 Jul 6.
PURPOSE: Determine incidence of shoulder arthroplasty complications identified on computed tomography (CT). MATERIALS AND METHODS: Retrospective institutional database review of patients with shoulder arthroplasties who underwent CT between 01/2006-11/2021 at a tertiary academic referral center with subspecialized orthopedic shoulder surgeons. CT reports were reviewed for arthroplasty type and complication. Data were stratified and summarized. Associations between complications and arthroplasty types were determined with Chi-squared goodness of fit test. RESULTS: Eight hundred twelve CTs in 797 unique patients were included (438 (53.9%) females and 374 (46.1%) males; mean age 67 ± 11 years). There were 403 total shoulder arthroplasties (TSA), 317 reverse total shoulder arthroplasties (rTSA), and 92 hemiarthroplasties (HA). Complications were present in 527/812 (64.9%) and incidences were: loosening/aseptic osteolysis 36.9%, periprosthetic failure 21.6%, periprosthetic fracture 12.3%, periprosthetic dislocation 6.8%, joint/pseudocapsule effusion 5.9%, prosthetic failure 4.8%, infection 3.8%, and periprosthetic collection 2.1%. Complications per arthroplasty were: 305/403 (75.7%) TSAs, 176/317 (55.5%) rTSAs, and 46/92 (50%) HAs (p < 0.001). Periprosthetic fracture (20.8%), prosthetic dislocation (9.8%), and prosthetic failure (7.9%) were highest in rTSAs (p < 0.001, p < 0.013, p < 0.001, respectively). Loosening/aseptic osteolysis most frequent in TSAs (54.1%) (p < 0.001). Periprosthetic failure most frequent in HA (32.6%) (p < 0.001). Significant associations were identified with joint/pseudocapsule effusion and loosening/aseptic osteolysis (p = 0.04) and prosthetic dislocation (p < .001). CONCLUSION: In this single tertiary academic referral center cohort, the incidence of shoulder arthroplasty complication identified on CT was 64.9% and the most commonly occurring complication was loosening/aseptic osteolysis (36.9%). TSA had the highest incidence of complication (75.7%).
目的:确定在计算机断层扫描(CT)上发现的肩关节置换术并发症的发生率。 材料与方法:对2006年1月至2021年11月在一家拥有专业骨科肩关节外科医生的三级学术转诊中心接受CT检查的肩关节置换术患者进行回顾性机构数据库审查。对CT报告进行审查,以确定置换术类型和并发症情况。对数据进行分层和总结。采用卡方拟合优度检验确定并发症与置换术类型之间的关联。 结果:纳入了797例独特患者的812次CT检查(438例(53.9%)女性和374例(46.1%)男性;平均年龄67±11岁)。共有403例全肩关节置换术(TSA)、317例反式全肩关节置换术(rTSA)和92例半肩关节置换术(HA)。527/812(64.9%)存在并发症,发生率分别为:松动/无菌性骨溶解36.9%、假体周围失败21.6%、假体周围骨折12.3%、假体周围脱位6.8%、关节/假包膜积液5.9%、假体失败4.8%、感染3.8%和假体周围积液2.1%。每种置换术的并发症情况为:403例TSA中有305例(75.7%)、317例rTSA中有176例(55.5%)、92例HA中有46例(50%)(p<0.001)。rTSA中假体周围骨折(20.8%)、假体脱位(9.8%)和假体失败(7.9%)的发生率最高(分别为p<0.001、p<0.013、p<0.001)。TSA中松动/无菌性骨溶解最为常见(54.1%)(p<0.001)。HA中假体周围失败最为常见(32.6%)(p<0.001)。发现关节/假包膜积液与松动/无菌性骨溶解(p=0.04)以及假体脱位(p<0.001)之间存在显著关联。 结论:在这个单一的三级学术转诊中心队列中,CT上发现的肩关节置换术并发症发生率为64.9%,最常见的并发症是松动/无菌性骨溶解(36.9%)。TSA的并发症发生率最高(75.7%)。
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