Fares Mohamad Y, Singh Jaspal, Boufadel Peter, Cohn Matthew R, Abboud Joseph A
Division of Shoulder and Elbow Surgery, Rothman Orthopedic Institute, Philadelphia, PA, USA.
Clin Shoulder Elb. 2024 Mar;27(1):117-125. doi: 10.5397/cise.2023.00024. Epub 2023 May 24.
While shoulder hemiarthroplasty is still used to treat young patients with shoulder pathology, the use of this procedure has substantially declined in recent years due to its significant complication profile. Glenoid wear with arthrosis is one of the major postoperative complications following shoulder hemiarthroplasty, and efforts to prevent this complication led many scientists to explore alternative weight-bearing surfaces on arthroplasty implants to decrease joint wear and improve patient outcomes. Pyrolytic carbon, or pyrocarbon, is a material that has better biocompatibility, survivorship, strength, and wear resistance compared to the materials used in traditional shoulder hemiarthroplasty. Pyrocarbon implants have been used in orthopedics for over 50 years; recently, their utility in shoulder hemiarthroplasty has garnered much interest. The purpose behind the use of pyrocarbon in shoulder hemiarthroplasty is to decrease the risk of progressive glenoid wear, especially in young active patients in whom joint preservation is important. Promising survivorship and outcomes have been demonstrated by recent studies, including limited glenoid wear following pyrocarbon hemiarthroplasty. Nevertheless, these clinical studies have been limited to relatively small case series with limited long-term follow-up. Accordingly, additional research and comparative studies need to be conducted in order to properly assess the therapeutic efficacy and value of pyrocarbon hemiarthroplasty.
虽然半肩关节置换术仍用于治疗患有肩部疾病的年轻患者，但由于其显著的并发症情况，近年来该手术的使用已大幅减少。关节盂磨损伴关节病是半肩关节置换术后的主要术后并发症之一，为预防这一并发症，许多科学家致力于探索关节置换植入物上的替代负重表面，以减少关节磨损并改善患者预后。热解碳，又称焦碳，与传统半肩关节置换术中使用的材料相比，具有更好的生物相容性、生存率、强度和耐磨性。热解碳植入物在骨科领域已使用超过50年；最近，它们在半肩关节置换术中的应用引起了广泛关注。在半肩关节置换术中使用热解碳的目的是降低关节盂渐进性磨损的风险，尤其是在关节保留很重要的年轻活跃患者中。最近的研究表明了热解碳半肩关节置换术有良好的生存率和预后，包括热解碳半肩关节置换术后关节盂磨损有限。然而，这些临床研究仅限于相对较小的病例系列，长期随访有限。因此，需要进行更多的研究和对比研究，以便正确评估热解碳半肩关节置换术的治疗效果和价值。
