Carroll Patrick J, Athwal George S
Hand and Upper Limb Centre, Western University, London, Ontario, Canada.
JSES Int. 2024 Jul 24;9(3):960-967. doi: 10.1016/j.jseint.2024.07.009. eCollection 2025 May.
Advances in technology have enabled implant designers and shoulder surgeons to strive towards improving implant survival and patient outcomes. Patient matched implants (PMIs) for arthroplasty have developed from the use of technologies such as computer aided design and computer-aided manufacturing technology and three-dimentional printing.
We conducted a computerized search of the electronic databases. We included studies which reported on PMI used in shoulder arthroplasty. Data were extracted by authors, publication year, study level, study type, demographic data (age, sex, sample size), type of arthroplasty, follow-up time, and outcomes.
5 studies were identified as being eligible for this analysis. 55 patients and 57 shoulders were included. The average age was 72.3 across 5 studies. Average follow-up was 28.26 months. 22/57 (39%) were for primary shoulder arthroplasty and 35/57 (61%) were revision procedures. 50/56 (89%) of shoulders improved. 7/56 (13%) of shoulder had a complication.
PMI for shoulder arthroplasty has so far only been used for severe glenoid bone loss in primary and revision shoulder arthroplasty. PMI can not only be used in the severe glenoid bone loss patient but there are some advantages to using it in the regular patient who attends seeking a shoulder arthroplasty. A limitation of our review is that there are no studies published on PMI for primary shoulder arthroplasty without significant glenoid bone loss. A paradigm shift in shoulder arthroplasty may occur where PMI is not only used for glenoid bone loss and challenging revision cases but also in primary shoulder arthroplasty without significant bone loss.
技术进步使植入物设计者和肩部外科医生能够努力提高植入物的存活率和患者预后。用于关节成形术的患者匹配植入物(PMI)是通过使用计算机辅助设计、计算机辅助制造技术和三维打印等技术发展而来的。
我们对电子数据库进行了计算机检索。我们纳入了报告肩部关节成形术中使用PMI的研究。数据由作者、发表年份、研究水平、研究类型、人口统计学数据(年龄、性别、样本量)、关节成形术类型、随访时间和结果提取。
5项研究被确定符合该分析的条件。纳入了55名患者和57个肩部。5项研究的平均年龄为72.3岁。平均随访时间为28.26个月。22/57(39%)为初次肩部关节成形术,35/57(61%)为翻修手术。50/56(89%)的肩部情况改善。7/56(13%)的肩部出现并发症。
到目前为止,肩部关节成形术的PMI仅用于初次和翻修肩部关节成形术中严重的肩胛盂骨丢失。PMI不仅可用于严重肩胛盂骨丢失的患者,在寻求肩部关节成形术的普通患者中使用也有一些优势。我们综述的一个局限性是,没有关于无明显肩胛盂骨丢失的初次肩部关节成形术使用PMI的研究发表。肩部关节成形术可能会发生范式转变,即PMI不仅用于肩胛盂骨丢失和具有挑战性的翻修病例,也用于无明显骨丢失的初次肩部关节成形术。