Ingoe Helen, Pareyon Roberto, Jomaa Mohammad N, Launay Marine, Italia Kristine, Maharaj Jashint, Gill David Rj, Holder Carl, Whitehouse Sarah L, Cutbush Kenneth, Gupta Ashish
Queensland Unit for Advanced Shoulder Research (QUASR), Brisbane, QLD, Australia.
Australian Shoulder Research Institute (ASRI), Brisbane, QLD, Australia.
JSES Int. 2025 Jan 3;9(3):761-770. doi: 10.1016/j.jseint.2024.11.025. eCollection 2025 May.
Evaluation of glenoid and humeral morphology is important prior to total shoulder arthroplasty and commonly measured on standard radiographs with further evaluation by computed tomography (CT). This study analyzed data from the Australian Orthopaedic Association National Joint Replacement Registry to assess the effect of glenoid morphology and preoperative CT scan on short-term implant survivorship.
The Australian Orthopaedic Association National Joint Replacement Registry identified all primary total stemless and stemmed anatomic total shoulder arthroplasties (aTSAs) and reverse total shoulder arthroplasties (rTSA) undertaken for all diagnoses during the period April 2004 to December 2022. The study population was grouped into glenoid morphology classified according to the Walch classification and to those with or without preoperative CT scan. The cumulative percent revision, which was defined using Kaplan-Meier estimates of survivorship to describe the time to the first revision, was calculated based upon glenoid morphology and CT scan availability. Hazard ratios from Cox proportional hazards models, adjusting for age and sex, were performed to compare the revision rates among groups.
There were 4071 (10.7%) primary stemmed aTSA, 3196 (8.4%) stemless aTSA and 30,702 (80.9%) primary rTSA included. Of these, 2694 (77%), 2543 (88.6%) and 21,007 (83.8%) patients had a preoperative CT scan, respectively. There was no difference in the cumulative percent revision at any time point between glenoid type A or B for any arthroplasty type. Glenoid morphology (type A or B) alone and in conjunction with a preoperative CT scan (yes or no) did not affect the revision rate in any combination for any arthroplasty type based on hazard ratio.
Preoperative glenoid morphology and preoperative CT scanning does not affect the early rate of revision of stemmed or stemless aTSA and rTSA. Future evaluations of CT scanning in this setting should consider other performance indicators such as patient reported outcome measures.
在进行全肩关节置换术前，评估肩胛盂和肱骨形态很重要，通常在标准X线片上进行测量，并通过计算机断层扫描（CT）进一步评估。本研究分析了澳大利亚骨科协会国家关节置换登记处的数据，以评估肩胛盂形态和术前CT扫描对短期植入物存活率的影响。
澳大利亚骨科协会国家关节置换登记处确定了2004年4月至2022年12月期间因所有诊断而进行的所有初次全无柄和有柄解剖型全肩关节置换术（aTSA）以及反向全肩关节置换术（rTSA）。研究人群根据Walch分类法分为肩胛盂形态组，以及有或没有术前CT扫描的组。使用Kaplan-Meier存活率估计值定义的累积翻修百分比来描述首次翻修的时间，并根据肩胛盂形态和CT扫描可用性进行计算。进行Cox比例风险模型的风险比分析，调整年龄和性别，以比较各组之间的翻修率。
纳入了4071例（10.7%）初次有柄aTSA、3196例（8.4%）无柄aTSA和30702例（80.9%）初次rTSA。其中，分别有2694例（77%）患者、2543例（88.6%）患者和21007例（83.8%）患者进行了术前CT扫描。对于任何一种关节置换类型，A或B型肩胛盂在任何时间点的累积翻修百分比均无差异。基于风险比，单独的肩胛盂形态（A或B型）以及与术前CT扫描（有或无）相结合，在任何组合中均不影响任何关节置换类型的翻修率。
术前肩胛盂形态和术前CT扫描不影响有柄或无柄aTSA以及rTSA的早期翻修率。在这种情况下，未来对CT扫描的评估应考虑其他性能指标，如患者报告的结局指标。
