Prada Carlos, Al-Mohrej Omar A, Siddiqui Salwa, Khan Moin
Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Shoulder Elbow. 2024 Oct;16(5):462-473. doi: 10.1177/17585732231192991. Epub 2023 Aug 7.
Glenoid loosening is an issue in anatomic total shoulder arthroplasty (a-TSA). This has been attributed to abnormal glenoid anatomy, common among these patients. Different alternatives have been proposed to tackle glenoid bone loss and restore joint alignment with augmented glenoid implants being increasingly used to deal with this problem. This systematic review aims to evaluate the clinical and radiological outcomes of patients undergoing augmented glenoid a-TSAs. Our hypothesis was that augmented glenoid components will lead to good patient outcomes with a low incidence of complications and revision procedures.
MEDLINE, EMBASE, CENTRAL and CINHAL were searched from inception to February 2022 for information pertaining to outcomes of patients undergoing a-TSA with augmented glenoid implants.
Eighteen studies reported on outcomes of 814 a-TSA (800 participants) with a mean follow-up of 3.7 years. Most studies (67%) were Type IV level of evidence. Almost 70% of participants underwent an a-TSA secondary to primary glenohumeral osteoarthritis. Most glenoids were type B2 (73%). Augmented glenoids material was mostly all-polyethylene (81%) with full wedge (45%) and stepped components (38%) designs being the most common. Most studies reported good clinical outcomes. 17 patients (4%) underwent a revision surgery.
Our review found that patients undergoing a-TSA with augmented glenoid components report good outcomes at short-to-mid-term follow-up. Further research is warranted to determine if such outcomes remain similar in long term.
Level III, Systematic Review of Therapeutic Studies.
盂肱关节松动是解剖型全肩关节置换术（a-TSA）中的一个问题。这归因于这些患者中常见的盂肱关节解剖结构异常。已经提出了不同的替代方案来解决盂肱关节骨质流失并恢复关节对线，越来越多地使用增强型盂肱关节植入物来处理这个问题。本系统评价旨在评估接受增强型盂肱关节a-TSA的患者的临床和放射学结果。我们的假设是，增强型盂肱关节组件将带来良好的患者预后，并发症和翻修手术的发生率较低。
检索MEDLINE、EMBASE、CENTRAL和CINHAL数据库，从建库至2022年2月，查找与接受带增强型盂肱关节植入物的a-TSA患者的预后相关的信息。
18项研究报告了814例a-TSA（800名参与者）的结果，平均随访3.7年。大多数研究（67%）为IV级证据。近70%的参与者因原发性盂肱关节炎接受了a-TSA。大多数盂肱关节为B2型（73%）。增强型盂肱关节材料大多为全聚乙烯（81%），全楔形（45%）和阶梯式组件（38%）设计最为常见。大多数研究报告了良好的临床结果。17例患者（4%）接受了翻修手术。
我们的综述发现，接受带增强型盂肱关节组件的a-TSA的患者在短期至中期随访中报告了良好的结果。有必要进行进一步研究以确定长期结果是否仍然相似。
III级，治疗性研究的系统评价。
