Gleich Johannes, Fleischhacker Evi, Lampert Christopher, Siebenbürger Georg, Ockert Ben, Böcker Wolfgang, Helfen Tobias
Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM) University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
Eur J Trauma Emerg Surg. 2025 Jan 20;51(1):29. doi: 10.1007/s00068-024-02724-3.
If surgery is indicated for elderly patients suffering a proximal humerus fracture, reverse fracture arthroplasty became the preferred type of treatment due to its good and reliable outcomes over the last decade. Surgeons could choose from a wide range of implants and up to now there was no evaluation, if a change of the manufacturer affects patients` outcome.
The last 100 patients before and the first 100 after manufacturer change in reverse fracture arthroplasty were evaluated at a level one trauma center, all treated by only 3 senior shoulder surgeons. Clinical as well as radiographic outcome parameters were assessed, perioperative up to 24 months after surgery.
Mean age in both groups was nearly 80 years with comparable distribution of gender and comorbidities. A trend to shorter duration of surgery was observed after the change, mainly according to an uncemented fixation of the stem. During follow-up no significant differences, beneficial as well as negative, could be observed regarding clinical and radiographic outcome.
A manufacturer change on the fly is possible without negative consequences for patients` outcome. Expertise of the whole OR-team as well as standardized training with the new implant seems to be a more important factor than a specific type of implant.
对于患有肱骨近端骨折的老年患者,如果需要进行手术,在过去十年中,由于其良好且可靠的治疗效果,反式骨折置换术已成为首选的治疗方式。外科医生可以从多种植入物中进行选择,到目前为止,尚无关于制造商的改变是否会影响患者治疗效果的评估。
在一家一级创伤中心对反式骨折置换术中制造商改变之前的最后100例患者和之后的前100例患者进行评估,所有患者均仅由3位资深肩部外科医生进行治疗。评估了临床和影像学结果参数,时间范围为围手术期至术后24个月。
两组患者的平均年龄均接近80岁,性别和合并症分布相当。制造商改变后观察到手术时间有缩短的趋势,主要是由于柄的非骨水泥固定。在随访期间,在临床和影像学结果方面未观察到显著差异,无论是有益的还是负面的。
随时更换制造商是可行的,且不会对患者的治疗效果产生负面影响。整个手术室团队的专业知识以及对新植入物的标准化培训似乎比特定类型的植入物更为重要。