Bond Elizabeth C, Finley Suzanne, Pennington Elizabeth, Reinke Emily K, McGarvey Lewis, Garrigues Grant E, Lassiter Tally E, Anakwenze Oke A
Duke Sports Sciences Institute, Division of Orthopaedics, Duke University, Durham, NC, USA.
Department of Orthopaedics, Rush University, Chicago, IL, USA.
J Shoulder Elb Arthroplast. 2024 Oct 17;8:24715492241291328. doi: 10.1177/24715492241291328. eCollection 2024.
When implanting a cemented humeral stem, a reliable method to prevent inappropriate extension and enable pressurization of cement in the intramedullary canal is required. The aim was to assess the outcomes of a dedicated humeral diaphyseal cement restrictor.
In total 218 shoulders (207 patients) were included in the study, all of whom underwent a cemented total shoulder arthroplasty and a retrospective review was performed. The primary outcomes of interest were device stability in the medullary canal, successful occlusion of the canal, cement extrusion and quality of cement mantle.
The majority of the cohort was female (63.3%) males and the average patient age was 71.7 years (SD 8.45). In 81.7% the device was deemed to be stable in the medullary canal. The device was significantly more stable in primary (84.2%) compared to revision cases (64.3%, p = 0.02). In 69.7% Barrack grade A mantle quality was achieved, this was higher in primary cases (74.2%) compared to revision cases (39.3%) (p = 0.00006).
We noted excellent cementation outcomes using a cement restrictor specifically designed for the diaphyseal humerus anatomy. However, this humeral specific restrictor was noted to be more stable in primary as compared to revision cases.
在植入骨水泥型肱骨干假体时，需要一种可靠的方法来防止不当延长，并使骨水泥在髓腔内加压。目的是评估一种专用的肱骨干骨水泥限制器的效果。
本研究共纳入218例肩部手术（207例患者），所有患者均接受了骨水泥型全肩关节置换术，并进行了回顾性分析。主要关注的结果是假体在髓腔内的稳定性、髓腔的成功封闭、骨水泥挤出情况以及骨水泥壳的质量。
队列中的大多数患者为女性（63.3%），男性患者的平均年龄为71.7岁（标准差8.45）。81.7%的假体在髓腔内被认为是稳定的。与翻修病例（64.3%，p = 0.02）相比，初次手术病例中假体的稳定性明显更高（84.2%）。69.7%的病例达到了Barrack A级骨水泥壳质量，初次手术病例（74.2%）高于翻修病例（39.3%）（p = 0.00006）。
我们注意到，使用专门为肱骨干解剖结构设计的骨水泥限制器，骨水泥固定效果极佳。然而，与翻修病例相比，这种专门针对肱骨的限制器在初次手术中更稳定。
