Smoak Jason B, Kluczynski Melissa A, DiPaola Matthew, Zuckerman Joseph D
School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
New York University Langone Health, New York, NY, USA.
JSES Rev Rep Tech. 2021 Jul 12;1(4):335-343. doi: 10.1016/j.xrrt.2021.06.001. eCollection 2021 Nov.
The aim of this systematic review was to summarize the clinical outcomes and associated predictors of outcomes for chronic glenohumeral dislocations treated with arthroplasty.
A systematic literature search was performed with Embase, PubMed, CENTRAL, BIOSIS, and CINAHL databases from the inception of these databases through January 1, 2021 to identify all articles that examined outcomes or predictors of outcomes of arthroplasty in patients with chronic glenohumeral dislocations. Studies that examined outcomes for patients with a chronic glenohumeral dislocation (≥3 weeks) treated with hemiarthroplasty, anatomic total shoulder arthroplasty, or reverse total shoulder arthroplasty were included. Those with acute or subacute dislocations (<3 weeks), fracture dislocations, and those treated with joint preserving treatment modalities were excluded.
We identified 195 articles; of which, 22 (201 patients/205 shoulders) met our inclusion criteria. A total of 14 studies reported outcomes of hemiarthroplasty, 10 studies reported outcomes of anatomic total shoulder arthroplasty, and 9 studies reported outcomes of reverse total shoulder arthroplasty. All studies documented clinical improvement after arthroplasty. Among 16 studies that measured range of motion, all 16 studies demonstrated improvement in range of motion postoperatively. Thirty-one reoperations (15%) were performed across all studies.
We found improved clinical outcomes after arthroplasty for the treatment of chronic glenohumeral fewer dislocations at a long-term follow-up. Some evidence suggests that reverse total shoulder arthroplasty may have superior outcomes and less complications compared with hemiarthroplasty and anatomic total shoulder arthroplasty. There is insufficient evidence regarding the potential influence that duration of dislocation, direction of dislocation, addition of concomitant procedures, or humeral component retroversion have on outcomes.
本系统评价的目的是总结关节成形术治疗慢性肩关节前脱位的临床结局及相关预后预测因素。
通过Embase、PubMed、CENTRAL、BIOSIS和CINAHL数据库进行系统文献检索，检索时间从各数据库建库至2021年1月1日，以确定所有研究慢性肩关节前脱位患者关节成形术结局或预后预测因素的文章。纳入研究半关节成形术、解剖型全肩关节置换术或反式全肩关节置换术治疗慢性肩关节前脱位（≥3周）患者的结局。排除急性或亚急性脱位（<3周）、骨折脱位以及采用保关节治疗方式的患者。
我们共识别出195篇文章；其中，22篇（201例患者/205个肩关节）符合纳入标准。共有14项研究报告了半关节成形术的结局，10项研究报告了解剖型全肩关节置换术的结局，9项研究报告了反式全肩关节置换术的结局。所有研究均记录了关节成形术后的临床改善情况。在16项测量活动范围的研究中，所有16项研究均显示术后活动范围有所改善。所有研究共进行了31次再次手术（15%）。
我们发现，长期随访时关节成形术治疗慢性肩关节前脱位可改善临床结局。一些证据表明，与半关节成形术和解剖型全肩关节置换术相比，反式全肩关节置换术可能具有更好的结局和更少的并发症。关于脱位持续时间、脱位方向、联合手术的附加操作或肱骨假体后倾对结局的潜在影响，证据不足。
