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使用定制基板治疗严重肩胛盂缺损的反式全肩关节置换术的早期结果

Early results of reverse total shoulder arthroplasty using a patient-specific baseplate to address severe glenoid deficiency.

作者信息

Moran Thomas E, Sumpter Anna E, Berry Carter J, Brockmeier Stephen F, Werner Brian C

机构信息

Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA.

出版信息

Shoulder Elbow. 2024 Oct;16(5):534-542. doi: 10.1177/17585732231200495. Epub 2023 Sep 7.

Abstract

BACKGROUND

The purpose of this study was to describe outcomes of patients undergoing reverse total shoulder arthroplasty (rTSA) using a patient-specific, custom glenoid component to address severe glenoid deficiency.

METHODS

Retrospective chart review identified patients at a single institution undergoing rTSA using the glenoid vault reconstruction system (VRS) between 2017 and 2022. Radiographic evaluation, range of motion and patient-reported outcome (PRO) measures, complications, and re-operations were assessed.

RESULTS

Fourteen shoulders were included. There was 100% implant survivorship of the glenoid baseplate at mean follow-up of 26.6 months. Mean range of motion improved in forward elevation (62-106 degrees), abduction (41-100 degrees), and external rotation (11-36 degrees). In 7 of 13 patients available for PRO collection, the mean final Visual Analog Pain Scale (VAS) score was 1.29, Single Assessment Numeric Evaluation (SANE) score was 72.14, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) score was 77.14, and Penn Shoulder score was 72.26.

CONCLUSIONS

Use of this custom glenoid resulted in encouraging clinical and radiographic outcomes, with no failures in implant survivorship seen at early follow-up. Larger prospective studies with longer-term follow-up should be undertaken in order to better determine the efficacy and longevity of this implant.

STUDY DESIGN

Retrospective case series; Level of evidence, 4.

摘要

背景

本研究的目的是描述采用定制的、针对严重关节盂缺损的个体化关节盂组件进行反向全肩关节置换术(rTSA)的患者的治疗结果。

方法

通过回顾性病历审查,确定了2017年至2022年间在单一机构接受使用关节盂穹窿重建系统(VRS)进行rTSA的患者。评估了影像学评估、活动范围和患者报告的结局(PRO)指标、并发症及再次手术情况。

结果

纳入14例肩部病例。关节盂基板的植入物生存率在平均26.6个月的随访期为100%。前屈(62 - 106度)、外展(41 - 100度)和外旋(11 - 36度)的平均活动范围均有所改善。在13例可收集PRO的患者中,7例患者的最终视觉模拟疼痛量表(VAS)平均评分为1.29,单项评估数字评价(SANE)评分为72.14,美国肩肘外科医师协会标准化肩部评估表(ASES)评分为77.14,宾夕法尼亚肩部评分为72.26。

结论

使用这种定制的关节盂取得了令人鼓舞的临床和影像学结果,早期随访中未见植入物生存失败情况。应开展更大规模的前瞻性研究并进行长期随访,以更好地确定该植入物的疗效和使用寿命。

研究设计

回顾性病例系列;证据等级,4级。

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