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本文引用的文献

1
Survivorship analysis of CAD-CAM total shoulder replacement.计算机辅助设计与制造(CAD-CAM)全肩关节置换术的生存分析
Shoulder Elbow. 2024 Jul;16(4):390-396. doi: 10.1177/17585732231193285. Epub 2023 Aug 7.
2
Trends in Shoulder Arthroplasty in Germany: A 10-Year Epidemiological Analysis of Patients with Primary Osteoarthritis of the Shoulder.德国肩关节置换术的趋势:对原发性肩关节骨关节炎患者的10年流行病学分析
Healthcare (Basel). 2024 May 6;12(9):949. doi: 10.3390/healthcare12090949.
3
Reverse total shoulder replacement versus anatomical total shoulder replacement for osteoarthritis: population based cohort study using data from the National Joint Registry and Hospital Episode Statistics for England.反向全肩关节置换与解剖型全肩关节置换治疗骨关节炎:基于英格兰国家关节登记处和医院入院统计数据的人群队列研究。
BMJ. 2024 Apr 30;385:e077939. doi: 10.1136/bmj-2023-077939.
4
Comparable low revision rates of stemmed and stemless total anatomic shoulder arthroplasties after exclusion of metal-backed glenoid components: a collaboration between the Australian and Danish national shoulder arthroplasty registries.排除金属背衬肩胛盂组件后,带柄和无柄全解剖肩假体的翻修率相当:澳大利亚和丹麦国家肩肘外科登记处的合作。
J Shoulder Elbow Surg. 2024 Dec;33(12):2619-2628. doi: 10.1016/j.jse.2024.03.022. Epub 2024 Apr 27.
5
Anatomical total shoulder arthroplasty revision to reverse shoulder arthroplasty using convertible glenoid: a systematic review of clinical and radiological outcomes.解剖型全肩关节置换翻修为反式肩关节置换术,使用可转换肩胛盂:临床和影像学结果的系统评价。
Int Orthop. 2024 Sep;48(9):2411-2419. doi: 10.1007/s00264-024-06188-3. Epub 2024 Apr 24.
6
Outcomes of a cementless onlay short stem reverse shoulder arthroplasty in elderly patients: a comprehensive analysis of clinical and radiological findings.非骨水泥型短柄反式肩关节置换术治疗老年患者的疗效:临床与影像学综合分析。
Arch Orthop Trauma Surg. 2024 May;144(5):2093-2099. doi: 10.1007/s00402-024-05321-6. Epub 2024 Apr 23.
7
The Influence of Component Design and Positioning on Soft-Tissue Tensioning and Complications in Reverse Total Shoulder Arthroplasty: A Review.组件设计和定位对反式全肩关节置换术中软组织张力和并发症的影响:综述。
JBJS Rev. 2024 Apr 4;12(4). doi: e23.00238. eCollection 2024 Apr 1.
8
Comparison between Anatomic Total Shoulder Arthroplasty and Reverse Shoulder Arthroplasty for Older Adults with Osteoarthritis without Rotator Cuff Tears.解剖型全肩关节置换术与反式肩关节置换术治疗伴或不伴肩袖撕裂的老年骨关节炎的比较。
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9
Outcomes after reverse shoulder arthroplasty for the treatment of glenohumeral osteoarthritis in patients under and over 70 years of age: a propensity score-matched analysis.70 岁以下和以上患者行反肩关节置换术治疗肩峰下关节骨关节炎的疗效比较:倾向评分匹配分析。
J Shoulder Elbow Surg. 2024 Jul;33(7):1547-1554. doi: 10.1016/j.jse.2023.11.022. Epub 2024 Jan 12.
10
Management of proximal humerus bone loss with allograft prosthetic composite technique in shoulder arthroplasty.肩关节置换术中同种异体骨-假体复合材料技术治疗肱骨近端骨缺损。
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老年人的肩关节置换术

Shoulder arthroplasty in the elderly.

作者信息

Raval P, Singh Harvinder

机构信息

Trauma and Orthopaedic, University Hospitals of Leicester, Leicester, United Kingdom.

University Hospitals of Leicester, Leicester, United Kingdom.

出版信息

J Clin Orthop Trauma. 2025 Mar 19;65:102976. doi: 10.1016/j.jcot.2025.102976. eCollection 2025 Jun.

DOI:10.1016/j.jcot.2025.102976
PMID:40235667
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11995757/
Abstract

BACKGROUND

Shoulder arthroplasty is increasingly being used for definitive treatment of various shoulder pathologies, especially in more elderly patients. Controversy surrounds the optimal choice in total shoulder arthroplasty for elderly patients. In this review we discuss the options available when considering TSA for an elderly patient.

REVIEW

Anatomical total shoulder arthroplasty (ATSA) relies upon an intact, functioning rotator cuff. Reverse total shoulder arthroplasty (RTSA) relies upon a functioning deltoid for optimal outcomes. The setting of partial cuff tears. Both options confer their own advantages and disadvantages.ATSA are a valuable treatment option for elderly patients with severe shoulder arthritis or degenerative conditions, offering significant pain relief and functional improvement. While it provides numerous advantages, including pain relief, preservation of bone stock, and natural joint mechanics, careful patient selection and consideration of potential drawbacks such as rotator cuff integrity and surgical complexity are crucial for optimising outcomes in this population.RTSA has become a valuable treatment solution for elderly patients with complex shoulder conditions, offering significant pain relief, improved functionality, and enhanced quality of life. While careful consideration of patient factors and potential complications is necessary, RTSA continues to demonstrate favourable outcomes and good survivorship in the elderly.

DISCUSSION

Debate continues optimal shoulder arthroplasty management for elderly patients. Technology continues to advance the surgical technique for shoulder arthroplasty and address some of the challenges encountered. Research continues to try and help answer many of the debated areas of shoulder arthroplasty, but current evidence continues to show an improving trend in survivorship and long-term outcomes for most shoulder arthroplasty procedures.

摘要

背景

肩关节置换术越来越多地用于各种肩部疾病的最终治疗,尤其是在老年患者中。老年患者全肩关节置换术的最佳选择存在争议。在本综述中,我们讨论为老年患者考虑全肩关节置换术时可用的选择。

综述

解剖型全肩关节置换术(ATSA)依赖于完整、功能正常的肩袖。反向全肩关节置换术(RTSA)依赖于功能正常的三角肌以获得最佳效果。部分肩袖撕裂的情况。两种选择都有其自身的优缺点。ATSA是患有严重肩部关节炎或退行性疾病的老年患者的一种有价值的治疗选择,可显著缓解疼痛并改善功能。虽然它具有许多优点,包括缓解疼痛、保留骨量和自然的关节力学,但仔细选择患者并考虑潜在的缺点,如肩袖完整性和手术复杂性,对于优化该人群的治疗效果至关重要。RTSA已成为患有复杂肩部疾病的老年患者的一种有价值的治疗方案,可显著缓解疼痛、改善功能并提高生活质量。虽然有必要仔细考虑患者因素和潜在并发症,但RTSA在老年患者中继续显示出良好的治疗效果和生存率。

讨论

关于老年患者最佳肩关节置换术管理的争论仍在继续。技术不断推动肩关节置换术的手术技术发展并解决一些遇到的挑战。研究继续试图帮助回答肩关节置换术许多有争议的领域,但目前的证据继续表明大多数肩关节置换术的生存率和长期效果呈改善趋势。