Smith Austin F, Collin Philippe, Elsenbsy Alaa, Zbinden Jeanni, Amiri Arash, Nabergoj Marko, Lädermann Alexandre
OrthoArizona, Phoenix, AZ, USA; University of Kansas School of Engineering, Lawrence, KS, USA.
CHP Saint-Grégoire, Saint-Grégoire, France; Clinique Victor Hugo, Paris, France; American Hospital of Paris, Neuilly-sur-Seine, France.
J Shoulder Elbow Surg. 2025 Jul;34(7):1613-1620. doi: 10.1016/j.jse.2024.10.001. Epub 2024 Dec 3.
There is a paucity of literature on manufacturer mismatch in reverse shoulder arthroplasty (RSA). It is unclear if the use of different implant manufacturers for the glenoid side and the humeral side influences patient outcomes in primary RSA. We hypothesize that patients undergoing primary RSA with manufacturer mismatch such that humeral and glenoid components are from different manufacturers will not experience adverse outcomes when compared to a cohort of patients with humeral and glenoid components from the same manufacturer.
Between January 2016 and June 2020, all patients who had an RSA implanted by one fellowship-trained shoulder surgeon were considered potentially eligible for inclusion in this retrospective analysis of data prospectively collected during a multicenter study. The inclusion criteria were as follows: primary RSAs implanted through a deltopectoral approach with glenoid and humeral components from different manufacturers, and complete data available at 2 years follow-up. The cohort was divided into a mismatch group and a control group, with the latter comprising patients having undergone RSA with components from the same manufacturer.
From the initial cohort, 191 patients were available for the 2-year clinical and radiological evaluation. Among these individuals were 60 men and 131 women, with a mean age of 74. The mismatch group comprised 39 patients and the control group included 152 patients. Baseline outcome scores of the mismatch and matched cohorts were similar regarding visual analog score (P = .220), Subjective Shoulder Value (P = .518), American Shoulder and Elbow Surgeons (P = .670), and Constant (P = .477) scores. Two-year postoperative outcome scores of the mismatched and matched cohorts were also similar regarding visual analog score (P = .716), Subjective Shoulder Value (P = .125), American Shoulder and Elbow Surgeons (P = .673), and Constant (P = .607) scores. The complication rate and radiological complications were similar.
Mixing of glenoid and humeral components from different manufacturers does not appear to affect patient outcomes in primary RSA at 2 years follow-up. The results may provide valuable information for orthopedic surgeons when selecting the appropriate implant components for RSA and help guide clinical decision-making for better patient outcomes. It appears reasonable to have manufacturer mismatch when appropriate matching of implant material and curvature at a given diameter is used.
关于反肩关节置换术（RSA）中制造商不匹配的文献较少。目前尚不清楚在初次RSA中，肩胛盂侧和肱骨头侧使用不同的植入物制造商是否会影响患者的预后。我们假设，与肱骨头和肩胛盂组件来自同一制造商的患者队列相比，接受初次RSA且制造商不匹配（即肱骨头和肩胛盂组件来自不同制造商）的患者不会出现不良预后。
在2016年1月至2020年6月期间，所有由一名接受过专科培训的肩部外科医生植入RSA的患者都被认为有可能纳入这项对多中心研究期间前瞻性收集的数据进行的回顾性分析。纳入标准如下：通过三角肌胸大肌入路植入的初次RSA，其肩胛盂和肱骨头组件来自不同制造商，且在2年随访时有完整的数据。该队列被分为不匹配组和对照组，后者包括接受了来自同一制造商组件的RSA的患者。
从最初的队列中，有191名患者可进行2年的临床和放射学评估。这些个体中有60名男性和131名女性，平均年龄为74岁。不匹配组包括39名患者，对照组包括152名患者。在视觉模拟评分（P = 0.220）、主观肩关节评分（P = 0.518）、美国肩肘外科医师协会评分（P = 0.670）和康斯坦特评分（P = 0.477）方面，不匹配队列和匹配队列的基线结果评分相似。在视觉模拟评分（P = 0.716）、主观肩关节评分（P = 0.125）、美国肩肘外科医师协会评分（P = 0.673）和康斯坦特评分（P = 0.607）方面，不匹配队列和匹配队列术后2年的结果评分也相似。并发症发生率和放射学并发症相似。
在2年随访时，不同制造商的肩胛盂和肱骨头组件混合使用似乎不会影响初次RSA患者预后。这些结果可能为骨科医生在为RSA选择合适的植入物组件时提供有价值的信息，并有助于指导临床决策以获得更好的患者预后。当在给定直径下适当匹配植入物材料和曲率时，制造商不匹配似乎是合理的。
