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初次反向全肩关节置换术中肩胛盂骨缺损的处理:一项批判性分析综述

Management of Glenoid Bone Loss in Primary Reverse Total Shoulder Arthroplasty: A Critical Analysis Review.

作者信息

Marigi Erick, Yu Kristin E, Vasquez-Loret Amanda, Baird Michael D, Hart Christopher M, Sperling John W, Sanchez-Sotelo Joaquin

机构信息

Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.

出版信息

JB JS Open Access. 2025 Aug 7;10(3). doi: 10.2106/JBJS.OA.25.00131. eCollection 2025 Jul-Sep.

Abstract

» A thorough understanding of glenoid deformity is essential to anticipate intraoperative needs and manage bony deficiencies. Management strategies include eccentric reaming, alternate scapular line baseplate orientation, bone grafting, or metallic augmentation as either "off-the-shelf" or custom baseplates. Accurate implantation of the glenoid component in the presence of glenoid bone loss (GBL) may also benefit from shoulderspecific guides, navigation, or robotic assistance. » GBL can negatively affect outcomes due to compromised bony fixation, altered soft tissue tensioning, and component malposition, which can contribute to impingement, dislocation, aseptic loosening, polyethylene wear, and component failure. » In this article, we provide a comprehensive review of published literature regarding the management of GBL in primary RSA and provide additional insight on the effectiveness of current approaches to manage bony deficiency.

摘要

对肩胛盂畸形有透彻的了解对于预测术中需求和处理骨缺损至关重要。处理策略包括偏心扩孔、肩胛线备用基板定向、骨移植或作为“现货”或定制基板的金属增强。在存在肩胛盂骨丢失(GBL)的情况下,肩胛盂部件的准确植入也可能受益于肩部特定导向器、导航或机器人辅助。GBL会因骨固定受损、软组织张力改变和部件位置不当而对手术结果产生负面影响,这可能导致撞击、脱位、无菌性松动、聚乙烯磨损和部件失效。在本文中,我们对已发表的关于原发性全肩关节置换术中GBL处理的文献进行了全面综述,并对当前处理骨缺损方法的有效性提供了更多见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7da3/12323907/fd7b43749231/jbjsoa-10-e25.00131-g001.jpg

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