Nyring Marc R K, Olsen Bo S, Jensen Steen L, Rasmussen Jeppe V
Department of Orthopedic Surgery, Herlev and Gentofte Hospital, Hellerup.
Department of Orthopedic Surgery, Aalborg University Hospital, Aalborg, Denmark.
Acta Orthop. 2024 Jul 17;95:386-391. doi: 10.2340/17453674.2024.41014.
There is controversy regarding the results of stemmed and stemless total shoulder arthroplasty (TSA) used for osteoarthritis. Therefore, we aimed to compare revision rates of stemmed and stemless TSA and to examine the impact of metal-backed glenoid components.
We included all patients reported to the Danish Shoulder Arthroplasty Register from January 1, 2012 to December 31, 2022 with an anatomical TSA used for osteoarthritis. Primary outcome was revision (removal or exchange of components) for any reason.
3,338 arthroplasties were included. The hazard ratio for revision of stemless TSA adjusted for age and sex was 1.83 (95% confidence interval [CI] 1.21-2.78) with stemmed TSA as reference. When excluding all arthroplasties with a metal-backed glenoid component, the adjusted hazard ratio for revision of stemless TSA was 1.37 (CI 0.85-2.20). For the Eclipse stemless TSA system, the adjusted hazard ratio for revision of a metal-backed glenoid component was 8.75 (CI 2.40-31.9) with stemless Eclipse with an all-polyethylene glenoid component as reference.
We showed that the risk of revision of stemless TSAs was increased and that it was related to their combination with metal-backed glenoid components.
对于用于骨关节炎的有柄和无柄全肩关节置换术（TSA）的结果存在争议。因此，我们旨在比较有柄和无柄TSA的翻修率，并研究金属背衬的关节盂组件的影响。
我们纳入了2012年1月1日至2022年12月31日向丹麦肩关节置换登记处报告的所有使用解剖型TSA治疗骨关节炎的患者。主要结局是因任何原因进行的翻修（取出或更换组件）。
共纳入3338例关节置换术。以有柄TSA为参照，调整年龄和性别后，无柄TSA翻修的风险比为1.83（95%置信区间[CI]1.21 - 2.78）。排除所有使用金属背衬关节盂组件的关节置换术后，无柄TSA翻修的调整后风险比为1.37（CI 0.85 - 2.20）。对于Eclipse无柄TSA系统，以使用全聚乙烯关节盂组件的无柄Eclipse为参照，金属背衬关节盂组件翻修的调整后风险比为8.75（CI 2.40 - 31.9）。
我们发现无柄TSA的翻修风险增加，且这与它们与金属背衬关节盂组件的组合有关。
