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肱骨反置半关节成形术的长期生存情况。

Long-term survival of resurfacing humeral hemiarthroplasty.

机构信息

Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, P.O. Box 1777, 70211, Kuopio, Finland.

Kuopio Musculoskeletal Research Unit (KMRU), Faculty of Health Sciences, University of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland.

出版信息

Eur J Orthop Surg Traumatol. 2024 Aug;34(6):2925-2932. doi: 10.1007/s00590-024-04010-9. Epub 2024 May 29.

Abstract

INTRODUCTION

The indication for shoulder resurfacing arthroplasty is controversial, and survival of these implants is somewhat inconsistent. This study aimed to evaluate the long-term survivorship of resurfacing humeral head implants (RHHIs) and determine risk factors for complications and revisions.

MATERIALS AND METHODS

This retrospective cohort study consisted of 275 cases and two types of RHHIs. The survival rate was evaluated using the Kaplan-Meier method and Cox regression for risk factor analysis. Demographic factors were studied, and the change in the humerus centre of rotation (COR) was measured.

RESULTS

The mean follow-up time was 8.7 years (SD 2.7 months, range 2.8-15.9 years). The mean age of the patients was 67.6 years (SD 9.6, range 33.5-84.9). Ten-year cumulative RHHI survival was 94.1%. The cumulative estimate without any complication was 98.9% at 5 years, 80.0% at 10 years and at 15 years it was 61.5%. The most common complication was persistent pain in 13.8% of the RHHIs. The risk factors for complications and revisions were implant type, preoperative conditions and change of COR > 5 mm.

CONCLUSIONS

RRHIs showed excellent long-term survival, but many complications were found. The most common complication was persistent pain, which seemed to be caused by a change of COR and was more related to one type of implant.

摘要

简介

肩关节表面置换术的适应证存在争议,且这些假体的存活率也不尽相同。本研究旨在评估表面置换肱骨头假体(RHHI)的长期存活率,并确定并发症和翻修的风险因素。

材料与方法

本回顾性队列研究纳入了 275 例患者和两种类型的 RHHI。采用 Kaplan-Meier 法和 Cox 回归进行生存率评估和风险因素分析。研究了人口统计学因素,并测量了肱骨头旋转中心(COR)的变化。

结果

平均随访时间为 8.7 年(SD 2.7 个月,范围 2.8-15.9 年)。患者平均年龄为 67.6 岁(SD 9.6,范围 33.5-84.9 岁)。10 年 RHHI 累积存活率为 94.1%。无任何并发症的累积估计值在 5 年时为 98.9%,10 年时为 80.0%,15 年时为 61.5%。最常见的并发症是 13.8%的 RHHI 持续疼痛。并发症和翻修的风险因素是假体类型、术前情况和 COR 变化>5mm。

结论

RHHI 显示出优异的长期存活率,但也发现了许多并发症。最常见的并发症是持续性疼痛,这似乎是 COR 变化引起的,与一种假体类型关系更密切。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14c3/11377525/b773043e80df/590_2024_4010_Fig1_HTML.jpg

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