Łukasiewicz Piotr, Harris Andrew B, Bervell Joel A, McFarland Edward G
Division of Shoulder Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Ann Jt. 2023 Jun 14;8:24. doi: 10.21037/aoj-23-9. eCollection 2023.
Reverse shoulder arthroplasty has become a common orthopaedic procedure, with a growing number of cases annually for multiple indications, such as rotator cuff arthropathy, osteoarthritis, or fractures of the proximal humerus, to reduce pain and restore shoulder mobility. Prosthesis design and various recent improvements aim to enhance range of motion (ROM) and stability and to limit component loosening and other potential complications. Many of these well-known issues could theoretically be improved by glenoid, humeral, or combined component lateralization. The objective of this article is to provide an up-to-date literature overview, present available options, and discuss the rationale behind lateralization of certain components, as well as their combined impact on outcomes of reverse shoulder arthroplasty.
PubMed and Scopus databases from 2003 to 2023 were searched and screened for studies, including systematic reviews, on the influence of glenoid, humeral, and combined component lateralization that served for narrative review of rationale behind such design.
Currently, a number of computer simulations, anatomic studies, and limited clinical references aim to support the rationale behind glenoid augmentation, variable humeral neck-shaft angle (NSA), or humeral tray design.
The utility of lateralization has not yet been clinically established. Randomized, long-term clinical outcome studies are still needed to reach a verdict going beyond surgeon preference and case-specific indications.
反式肩关节置换术已成为一种常见的骨科手术，每年因多种适应症（如肩袖关节病、骨关节炎或肱骨近端骨折）而进行的病例数量不断增加，以减轻疼痛并恢复肩关节活动度。假体设计及近期的各种改进旨在扩大活动范围（ROM）并提高稳定性，同时限制假体松动及其他潜在并发症。从理论上讲，通过肩胛盂、肱骨头或组合部件的外移，许多这些众所周知的问题可以得到改善。本文的目的是提供最新的文献综述，介绍可用的选择，并讨论某些部件外移背后的原理，以及它们对反式肩关节置换术结果的综合影响。
检索并筛选了2003年至2023年PubMed和Scopus数据库中的研究，包括关于肩胛盂、肱骨头和组合部件外移影响的系统评价，以对这种设计背后的原理进行叙述性综述。
目前，一些计算机模拟、解剖学研究和有限的临床参考文献旨在支持肩胛盂扩大、可变肱骨干颈角（NSA）或肱骨头假体设计背后的原理。
外移的效用尚未在临床上得到证实。仍需要进行随机、长期的临床结果研究，以得出超越外科医生偏好和特定病例适应症的结论。
