Pereira Catarina, Carrapatoso Manuel, Barros Luís H, Claro Rui
Department of Orthopaedics, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Shoulder Elbow. 2024 Jul 25:17585732241262524. doi: 10.1177/17585732241262524.
The implications of notching in reverse shoulder arthroplasty (RSA), and its relation with the rate of complications are still unclear. Our main aim was to retrospectively study the notching incidence in the three most used implants in our practice, considering their different neck-shaft angle (NSA) and determine its relation with implant failure, or other complications.
We retrospectively reviewed medical and imaging records of 259 patients who underwent RSA in our hospital, including surgery reports, prosthesis designs and techniques. We assessed all radiographs taken during the follow up to evaluate notching incidence, progression and signs of failure.
Notching occurred in 35% cases. The average time to notch development was 19 months. Implants with a lower NSA showed significantly lower incidence of notching when compared to other implants ( < 0.001). In a multivariate analysis, the NSA proved to be an independent predictor for the occurrence of notching in this series.
According to our results, higher NSA is an independent predictor of the occurrence of notching. There was significant increase in the notching rate with follow up. In the future, larger case series with longer follow-up are necessary to evaluate the relation between notching and radiological and clinical complications.
在反肩关节置换术（RSA）中，骨切迹的影响及其与并发症发生率的关系仍不明确。我们的主要目的是回顾性研究我们临床实践中最常用的三种植入物的骨切迹发生率，考虑它们不同的颈干角（NSA），并确定其与植入物失败或其他并发症的关系。
我们回顾性分析了我院259例行RSA患者的医疗和影像记录，包括手术报告、假体设计和技术。我们评估了随访期间拍摄的所有X线片，以评估骨切迹发生率、进展情况和失败迹象。
35%的病例出现骨切迹。骨切迹出现的平均时间为19个月。与其他植入物相比，NSA较低的植入物骨切迹发生率显著较低（<0.001）。在多变量分析中，NSA被证明是该系列中骨切迹发生的独立预测因素。
根据我们的结果，较高的NSA是骨切迹发生的独立预测因素。随访期间骨切迹发生率显著增加。未来，需要更大规模、更长随访时间的病例系列来评估骨切迹与放射学和临床并发症之间的关系。
