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无柄反向全肩关节置换术的影像学和临床结果:一项至少2年的随访研究。

The radiographic and clinical outcomes of stemless reverse total shoulder arthroplasty: a minimum 2-year follow-up study.

作者信息

Choi Chang-Hyuk, Choi Ji Hoon, Che Sug Hun, Kim Jun-Young

机构信息

Department of Orthopedic Surgery, Daegu Catholic University School of Medicine, Daegu, Korea.

出版信息

Clin Shoulder Elb. 2024 Dec;27(4):428-436. doi: 10.5397/cise.2024.00472. Epub 2024 Oct 18.

Abstract

BACKGROUND

The purpose of this study was to examine the radiographic and clinical outcomes of stemless reverse total shoulder arthroplasty (RTSA) after a minimum 2-year follow-up.

METHODS

Between July 2018 and March 2023, 50 patients underwent 50 stemless RTSA with the Lima component. Twenty-eight patients with a follow-up of more than 2 years were reviewed. The average age was 71.9 years (range, 61-85 years), and the average follow-up period was 2.2 years (range, 2.0-5.1 years). Bone marrow density of the proximal humerus was measured before RTSA. We evaluated preoperative and postoperative range of motion, clinical score, radiographic change, and postoperative complications.

RESULTS

Significant increases were observed postoperatively in forward flexion (112.0°-162.5°, P<0.01) and internal rotation (from L3 to T12 level, P<0.05). No changes were observed in external rotation (from 43.0° to 45.2°, P=0.762). The clinical scores improved for Korean Shoulder Scoring system (from 64 to 93, P<0.01) and American Shoulder and Elbow Surgeons score (from 17.5 to 27.3, P<0.01). Although radiolucent lines of less than 2 mm were observed in all cases, no osteolysis and loosening of the stemless humeral component was found. Scapular notching was observed in 18 cases (64.3%).

CONCLUSIONS

Stemless RTSA showed good radiographic and clinical results after a minimum 2-year follow-up. Level of evidence: IV.

摘要

背景

本研究的目的是在至少2年的随访后,检查无柄反向全肩关节置换术(RTSA)的影像学和临床结果。

方法

2018年7月至2023年3月期间,50例患者接受了50例使用利马组件的无柄RTSA手术。对28例随访超过2年的患者进行了回顾。平均年龄为71.9岁(范围61 - 85岁),平均随访期为2.2年(范围2.0 - 5.1年)。在RTSA术前测量肱骨近端的骨髓密度。我们评估了术前和术后的活动范围、临床评分、影像学变化以及术后并发症。

结果

术后前屈(从112.0°增加到162.5°,P<0.01)和内旋(从L3水平到T12水平,P<0.05)有显著增加。外旋无变化(从43.0°到45.2°,P = 0.762)。韩国肩关节评分系统的临床评分有所改善(从64分提高到93分,P<0.01),美国肩肘外科医生评分也有所提高(从17.5分提高到27.3分,P<0.01)。尽管所有病例均观察到小于2 mm的透亮线,但未发现无柄肱骨组件的骨溶解和松动。18例(64.3%)观察到肩胛切迹。

结论

至少2年的随访后,无柄RTSA显示出良好的影像学和临床结果。证据级别:IV级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b048/11615466/a4e6633b9db1/cise-2024-00472f1.jpg

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