Gruber Maxwell D, Kirloskar Kunal M, Werner Brian C, Lädermann Alexandre, Denard Patrick J
Elson S. Floyd College of Medicine, Spokane, WA, USA.
Georgetown University School of Medicine, Washington, DC, USA.
JSES Rev Rep Tech. 2022 Jan 25;2(2):117-124. doi: 10.1016/j.xrrt.2021.12.007. eCollection 2022 May.
Reverse shoulder arthroplasty (RSA) leads to improvement in pain and function with a durable outcome in most cases. While improvement in forward flexion and to a lesser degree external rotation is predictably seen after RSA, restoration of internal rotation (IR) is much less predictable. The purpose of this review was to provide a narrative of the modifiable factors, including prosthetic design and surgical factors, that may impact postoperative IR after RSA. Overall, the available data suggest that postoperative IR is improved with a lower humeral neck shaft angle and lateralization of the glenoid. Decreasing humeral retroversion to 20° or less improves IR at the cost of decreasing active external rotation. Increasing glenosphere diameter improves IR but often within the setting of additional variables. The association between subscapularis repair is less clear but overall suggests that IR is improved postoperatively when it is repaired.
反肩关节置换术（RSA）在大多数情况下能改善疼痛和功能，且疗效持久。虽然RSA术后可预见地会出现前屈改善，外旋改善程度较小，但内旋（IR）的恢复则难以预测得多。本综述的目的是阐述一些可调节因素，包括假体设计和手术因素，这些因素可能会影响RSA术后的IR。总体而言，现有数据表明，较低的肱骨干颈角和肩胛盂外移可改善术后IR。将肱骨后倾角减小至20°或更小可改善IR，但代价是主动外旋减少。增加球窝关节面直径可改善IR，但通常需要在其他变量的背景下。肩胛下肌修复之间的关联尚不清楚，但总体表明修复后IR在术后会得到改善。
