Waseem S, Dragonas C, Kinnair A, Leivadiotou D
Department of Trauma and Orthopaedics, Princess Alexandra Hospital, Hamstel Road, Harlow, Essex, CM201QX, England.
Arch Orthop Trauma Surg. 2025 Jun 4;145(1):329. doi: 10.1007/s00402-025-05897-7.
Lateralisation in reverse shoulder arthroplasty can be achieved through bone graft (BIO-RSA) or metal augments (MIO-RSA). This systematic review and meta-analysis aimed to compare outcomes in both these methods.
A systematic review of Pubmed, Cochrane, Medline and EMBASE was performed including all studies on primary reverse total shoulder replacements with lateralised glenoid components using either bone graft (BIO-RSA) or metal augments (MIO-RSA). Collected data for included studies included demographics, method of lateralisation and complications.
30 studies comprising 2364 shoulders in 2558 patients were included, with a mean age of 72.8 (23-93), and 59.7% being female. 1026 patients underwent BIO-RSA and 1328 underwent arthroplasty with metal augmented glenoid components. After 31.5 months (3-126) follow-up, there was a significantly lower pain score (p < 0.05) and higher ASES (p < 0.05) and UCLA (p < 0.05) scores in patients post MIO-RSA, but no significant difference in range of movement post-operatively. Moreover, there was lower rates of revisions (1.3% v 3.0%, p < 0.01), loosening (0.8% v 2.4%, p < 0.01) and scapular notching (3.8% v 17.3%, p < 0.01) in the MIO-RSA group.
BIO-RSA and MIO-RSA outcomes are summarised, suggesting preliminary evidence of some superiority of MIO-RSA, but heterogeneity in the selected studies limits the conclusions that can be drawn from results. Long term studies are required to ascertain if this effect is maintained.
反向全肩关节置换术中的侧方化可通过植骨（生物反向全肩关节置换术，BIO-RSA）或金属垫块（金属增强反向全肩关节置换术，MIO-RSA）来实现。本系统评价和荟萃分析旨在比较这两种方法的疗效。
对PubMed、Cochrane、Medline和EMBASE进行系统评价，纳入所有关于使用植骨（BIO-RSA）或金属垫块（MIO-RSA）进行侧方化盂肱关节组件的初次反向全肩关节置换术的研究。纳入研究收集的数据包括人口统计学、侧方化方法和并发症。
纳入30项研究，共2558例患者的2364个肩关节，平均年龄72.8岁（23 - 93岁），女性占59.7%。1026例患者接受了BIO-RSA，1328例患者接受了金属增强盂肱关节组件的关节置换术。经过31.5个月（3 - 126个月）的随访，MIO-RSA术后患者的疼痛评分显著更低（p < 0.05），美国肩肘外科医师学会（ASES）评分（p < 0.05）和加州大学洛杉矶分校（UCLA）评分更高（p < 0.05），但术后活动范围无显著差异。此外，MIO-RSA组的翻修率（1.3%对3.0%，p < 0.01）、松动率（0.8%对2.4%，p < 0.01）和肩胛切迹发生率（3.8%对17.3%，p < 0.01）更低。
总结了BIO-RSA和MIO-RSA的疗效，提示有初步证据表明MIO-RSA有一定优势，但所选研究的异质性限制了从结果中得出的结论。需要长期研究来确定这种效果是否能持续保持。
