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展望未来:肩关节置换术技术的全面综述

Navigating the future: A comprehensive review of technology in shoulder arthroplasty.

作者信息

Hill J Ryan, Jackson Garrett R, To William, Zmistowski Benjamin, Movassaghi Aghdas, Sabesan Vani J

机构信息

University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA.

University of Missouri, Department of Orthopaedic Surgery, Columbia, MO, USA.

出版信息

J Hand Microsurg. 2025 Feb 4;17(3):100224. doi: 10.1016/j.jham.2025.100224. eCollection 2025 May.

Abstract

UNLABELLED

The volume of shoulder arthroplasty (SA) procedures has increased significantly in recent years, outpacing the growth of hip and knee arthroplasty. As a relatively young area in orthopedics, shoulder arthroplasty offers many opportunities for innovation, often borrowing from established practices in other subspecialties. Degenerative shoulder pathology presents unique challenges that can be difficult to adequately address with conventional reconstructive methods alone. Currently, three-dimensional preoperative planning is the most widely utilized technology in shoulder arthroplasty. Implementation of patient-specific instrumentation is increasing, primarily for patients with severe deformity. Computer-assisted navigation, widely used in hip and knee reconstruction, is gaining traction. These technologies have demonstrated increased accuracy and precision in correcting glenoid deformity and implant positioning, which are known to influence the long-term performance of SA. However, studies specifically evaluating the long-term clinical benefits of these innovations are lacking. In the near future, the application of robotic and immersive technologies like augmented reality for SA demonstrates promise for enhancing the surgeon's ability to address glenoid deformity intraoperatively. These advancements provide exciting opportunities to transform the field of shoulder arthroplasty, yet they must be critically evaluated for their cost and impact to outcomes clinical cohorts with long-term follow-up.

LEVEL OF EVIDENCE

Level V; Narrative Review.

摘要

未标注

近年来,肩关节置换术(SA)的手术量显著增加,超过了髋关节和膝关节置换术的增长速度。作为骨科中一个相对较新的领域,肩关节置换术提供了许多创新机会,常常借鉴其他亚专业的成熟做法。退行性肩部病变带来了独特的挑战,仅用传统的重建方法往往难以充分解决。目前,三维术前规划是肩关节置换术中应用最广泛的技术。针对特定患者的器械使用正在增加,主要用于严重畸形的患者。广泛应用于髋关节和膝关节重建的计算机辅助导航也越来越受到关注。这些技术在纠正盂肱关节畸形和植入物定位方面已显示出更高的准确性和精确性,而这些已知会影响肩关节置换术的长期效果。然而,缺乏专门评估这些创新技术长期临床益处的研究。在不久的将来,机器人技术和增强现实等沉浸式技术在肩关节置换术中的应用有望提高外科医生术中处理盂肱关节畸形的能力。这些进展为变革肩关节置换领域提供了令人兴奋的机会,但必须对其成本以及对长期随访的临床队列结果的影响进行严格评估。

证据级别

V级;叙述性综述。

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Navigation in Shoulder Arthroplasty Surgery.肩关节置换手术中的导航
Rev Bras Ortop (Sao Paulo). 2020 Nov 23;57(4):540-545. doi: 10.1055/s-0040-1712989. eCollection 2022 Aug.
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Biomechanics of anatomic and reverse shoulder arthroplasty.解剖型和反置式肩关节置换术的生物力学
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