Douven Dirk P M, Geijsen Gert-Jan P, van Kampen Paulien M, Heijnen Stefan A F
Department of Research and Innovation, Bergman Clinics, Naarden, the Netherlands.
Department of Orthopaedic Surgery, Bergman Clinics, Breda, the Netherlands.
J Shoulder Elbow Surg. 2025 Apr;34(4):1016-1023. doi: 10.1016/j.jse.2024.07.028. Epub 2024 Sep 5.
This retrospective, observational study aimed to assess the revision rates and survival curves in total shoulder arthroplasty (TSA) and hemi-shoulder arthroplasty (HSA) patients, including a subanalysis to investigate the impact of a pyrocarbon humeral head in revision rates.
Data collected from 7 surgeons who performed primary HSA in 92 patients and primary TSA in 508 patients at a large private clinic were analyzed. The study focused on revision rates and identified factors leading to revisions, including rotator cuff insufficiency, dislocation, aseptic loosening, implant material, and glenoid erosion.
The overall revision rate for HSA was found to be significantly higher (7.6%) than that for TSA (1.2%), with a maximum follow-up of 7 years. Subanalysis within the HSA group revealed a notably higher revision rate in cases involving a metal head (cobalt-chrome or titanium) (12.8%) than those with a pyrocarbon head (2.3%).
This study underscores the importance of distinguishing between TSA and HSA when evaluating shoulder arthroplasty outcomes. The significantly higher revision rate in HSA, particularly with metal heads, suggests the need for careful consideration of implant selection to optimize long-term success in shoulder arthroplasty procedures.
这项回顾性观察研究旨在评估全肩关节置换术（TSA）和半肩关节置换术（HSA）患者的翻修率和生存曲线，包括一项亚分析以研究热解碳肱骨头对翻修率的影响。
分析了从一家大型私人诊所的7名外科医生处收集的数据，这些医生对92例患者进行了初次HSA，对508例患者进行了初次TSA。该研究重点关注翻修率，并确定导致翻修的因素，包括肩袖功能不全、脱位、无菌性松动、植入材料和肩胛盂侵蚀。
发现HSA的总体翻修率（7.6%）显著高于TSA（1.2%），最长随访7年。HSA组内的亚分析显示，涉及金属头（钴铬或钛）的病例的翻修率（12.8%）明显高于热解碳头的病例（2.3%）。
本研究强调了在评估肩关节置换术结果时区分TSA和HSA的重要性。HSA中显著更高的翻修率，尤其是金属头的情况，表明需要仔细考虑植入物的选择，以优化肩关节置换手术的长期成功率。
