Kang Hean Wu, Child Christopher, Italia Kristine, Karel Mirek, Gilliland Luke, Ingoe Helen, Maharaj Jashint, Whitehouse Sarah, Cutbush Kenneth, Gupta Ashish
Queensland Unit for Advanced Shoulder Research (QUASR), Queensland University of Technology (QUT), Brisbane, QLD 4000, Australia.
Australian Shoulder Research Institute, Brisbane, QLD 4000, Australia.
J Clin Med. 2024 Oct 21;13(20):6290. doi: 10.3390/jcm13206290.
: Proximal humeral bone deficiency in revision shoulder arthroplasty is an emerging and challenging problem as the use of reverse shoulder arthroplasty (RSA) increases. This paper presents a technical note discussing our detailed preoperative planning steps, surgical techniques, and their rationale in carrying out the use of an allograft prosthetic composite (APC) to address proximal humeral bone deficiency in revision RSA. The outcomes of this technique are also presented. This paper also presents a systematic review to further discuss the existing literature on RSA with APCs. : The preoperative surgical planning and the surgical technique employed to execute proximal humeral reconstruction using APC during revision arthroplasty are discussed in the technical note. The preliminary clinical and radiological results of five patients who underwent revision shoulder arthroplasty with proximal humeral reconstruction using APCs are presented. The PRISMA guidelines were followed to perform the systematic review. A systematic search using PubMed, Embase, and Cochrane databases was conducted. All studies involving RSA and APCs were pooled, and the data were extracted and analyzed. : A total of 14 studies were eligible for inclusion in the systematic review, with a total of 255 patients and a mean follow-up of 57 months. All studies in the systematic review and the patients included in the author's case series showed improvements in the level of pain, range of motion, function, and satisfaction. Graft incorporation in the systematic review was 84%. : Based on the available literature and the results of our case series, the use of an APC construct is a viable option for proximal humeral bone deficiency in revision shoulder arthroplasty.
随着反肩关节置换术（RSA）应用的增加，翻修肩关节置换术中肱骨近端骨缺损成为一个新出现且具有挑战性的问题。本文呈现一篇技术说明，讨论我们在使用同种异体骨假体复合物（APC）解决翻修RSA中肱骨近端骨缺损时详细的术前规划步骤、手术技术及其原理。还展示了该技术的结果。本文还进行了一项系统综述，以进一步讨论关于使用APC进行RSA的现有文献。
在技术说明中讨论了翻修关节置换术中使用APC进行肱骨近端重建的术前手术规划和所采用的手术技术。展示了五例接受使用APC进行肱骨近端重建的翻修肩关节置换术患者的初步临床和影像学结果。遵循PRISMA指南进行系统综述。使用PubMed、Embase和Cochrane数据库进行了系统检索。纳入了所有涉及RSA和APC的研究，并对数据进行提取和分析。
共有14项研究符合纳入系统综述的条件，共计255例患者，平均随访57个月。系统综述中的所有研究以及作者病例系列中的患者均显示疼痛程度、活动范围、功能和满意度有所改善。系统综述中移植物融合率为84%。
基于现有文献和我们病例系列的结果，对于翻修肩关节置换术中的肱骨近端骨缺损，使用APC结构是一种可行的选择。
