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可转换平台肩关节置换术。

Convertible-platform shoulder arthroplasty.

作者信息

Kelly Shayne R, Touhey Daniel C, Smith Matthew J

机构信息

Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA.

School of Medicine, University of Missouri, Columbia, MO, USA.

出版信息

JSES Rev Rep Tech. 2023 Oct 17;4(3):594-599. doi: 10.1016/j.xrrt.2023.09.010. eCollection 2024 Aug.

Abstract

BACKGROUND

Shoulder arthroplasty has become an increasingly common procedure used to treat degenerative, inflammatory, and traumatic conditions of the glenohumeral joint. With a significant increase in primary anatomic and reverse total shoulder arthroplasty, revision procedures have likewise increased. Updates in shoulder arthroplasty have allowed for the convertibility of implants, which allows for the retention of both glenoid and humeral components during revision surgery. This review aims to highlight the epidemiology, indications, and outcomes of convertible-platform total shoulder arthroplasty procedures.

METHODS

A review of the current literature surrounding convertible-platform shoulder arthroplasty was completed to highlight the advantages and disadvantages of commercially available instrumentation and implant systems as well as their outcomes.

DISCUSSION

Leading causes of shoulder arthroplasty revision surgery include glenoid failure, implant instability, and rotator cuff dysfunction. Variations in implant design between inlay and onlay humeral components and metal-backed glenoid components are important considerations at the time of revision surgery. Advantages of convertible-platform systems include increased efficiency and decreased complications during revision procedures as well as shorter recovery, lower cost, and better functional outcomes. Limitations of convertible systems include poorly positioned components during the index procedure, excessive soft-tissue tensioning, and problems associated with metal-backed glenoid implants. Changes in arm length have also been documented. These findings indicate the benefit of additional research and design to improve the effectiveness and utility of convertible-platform shoulder arthroplasty systems.

摘要

背景

肩关节置换术已成为治疗盂肱关节退行性、炎性和创伤性疾病越来越常用的手术。随着初次解剖型和反式全肩关节置换术显著增加,翻修手术也相应增加。肩关节置换术的进展使得植入物具有可转换性,这使得在翻修手术中能够保留肩胛盂和肱骨头组件。本综述旨在强调可转换平台全肩关节置换术的流行病学、适应证和治疗结果。

方法

对围绕可转换平台肩关节置换术的当前文献进行综述,以突出市售器械和植入系统的优缺点及其治疗结果。

讨论

肩关节置换术翻修手术的主要原因包括肩胛盂失效、植入物不稳定和肩袖功能障碍。在翻修手术时,镶嵌式和覆盖式肱骨头组件以及金属背衬肩胛盂组件之间的植入物设计差异是重要的考虑因素。可转换平台系统的优点包括翻修手术期间效率提高和并发症减少,以及恢复时间缩短、成本降低和功能结果更好。可转换系统的局限性包括初次手术时组件位置不佳、软组织过度张紧以及与金属背衬肩胛盂植入物相关的问题。也有关于手臂长度变化的记录。这些发现表明需要进一步研究和设计,以提高可转换平台肩关节置换术系统的有效性和实用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9898/11329054/000abc9dae86/gr1.jpg

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