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采用无柄肱骨头假体的扩髓与植入式肩关节置换术的疗效

Outcomes of ream and run shoulder arthroplasty with a stemless humeral component.

作者信息

Cohn Matthew R, Luthringer Tyler A, Kane Liam T, Vaughn Alayna K, Kwak Daniel, Namdari Surena, Lazarus Mark D

机构信息

Summit Health Orthopedics, Berkeley Heights, NJ, USA.

Department of Orthopedics, Rothman Institute, Philadelphia, PA, USA.

出版信息

Shoulder Elbow. 2025 Aug 7:17585732251362328. doi: 10.1177/17585732251362328.

DOI:10.1177/17585732251362328
PMID:40787241
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12331637/
Abstract

BACKGROUND

Diaphyseal engaging standard-length stems are commonly used for the ream-and-run (RnR) procedure. Stemless humeral components have grown in popularity and preserve metaphyseal bone while shortening operative times. No studies have yet reported on clinical outcomes of RnR using a stemless humeral component.

METHODS

All patients undergoing RnR with a stemless humeral component at a single institution between January 2017 and May 2021 were retrospectively reviewed. Preoperative radiographs were assessed for Walch Classification, glenoid version, and posterior humeral head decentering. Glenoid version and posterior humeral head decentering were assessed on three months postoperative radiographs and clinical outcomes were assessed at minimum 2 years postoperatively.

RESULTS

Eighteen shoulders among 17 patients were included; 15 (88%) returned to exercise at a median of 16 weeks. Minimum 2-year outcome scores showed a mean Visual Analog Scale of 2.5, American Shoulder Elbow Surgeons score of 79.6, Simple Shoulder Test of 9.9, and Single Assessment Numeric Evaluation score of 80. Radiographically, corrective humeral head recentering within 5% was observed in 64% of cases.

DISCUSSION

Clinical and radiographic outcomes suggest that stemless implants may yield comparable patient-reported outcomes to stemmed implants with advantages of preserved bone stock and shorter operative times.

摘要

背景

骨干嵌入标准长度的假体柄常用于扩髓插入(RnR)手术。无柄肱骨假体越来越受欢迎,它能保留干骺端骨质并缩短手术时间。目前尚无关于使用无柄肱骨假体进行RnR手术临床结果的研究报道。

方法

对2017年1月至2021年5月在单一机构接受无柄肱骨假体RnR手术的所有患者进行回顾性分析。术前X线片评估Walch分类、关节盂形态及肱骨头后倾情况。术后3个月X线片评估关节盂形态及肱骨头后倾情况,术后至少2年评估临床结果。

结果

纳入17例患者的18个肩关节;15例(88%)在术后16周时恢复运动。至少2年的结果评分显示,视觉模拟量表平均分为2.5分,美国肩肘外科医师协会评分为79.6分,简单肩关节测试评分为9.9分,单项评估数值评分为80分。影像学检查显示,64%的病例肱骨头矫正复位在5%以内。

讨论

临床和影像学结果表明,无柄假体可能产生与有柄假体相当的患者报告结果,且具有保留骨量和缩短手术时间的优势。

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Comparison of short- and midterm outcomes in patients following ream-and-run and anatomic total shoulder arthroplasties.扩髓-冲洗-再植入术与解剖型全肩关节置换术后患者短期和中期疗效的比较。
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Early outcome of humeral head replacement with glenoid reaming arthroplasty (Ream and Run) for treatment of advanced glenohumeral osteoarthritis.肱骨近端置换联合盂肱关节扩孔成形术(Ream and Run)治疗晚期肩关节炎的早期疗效。
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Current Technique for the Ream-and-Run Arthroplasty for Glenohumeral Osteoarthritis.用于治疗盂肱关节骨关节炎的扩髓-插入式关节成形术的当前技术
JBJS Essent Surg Tech. 2012 Oct 10;2(4):e20. doi: 10.2106/JBJS.ST.L.00009. eCollection 2012 Oct.
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Single Assessment Numeric Evaluation (SANE) is a reliable metric to measure clinically significant improvements following shoulder arthroplasty.单一评估数值评估(SANE)是一种可靠的度量标准,可用于衡量肩关节置换术后临床显著改善的情况。
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Radiographic outcomes of impaction-grafted standard-length humeral components in total shoulder and ream-and-run arthroplasty: is stress shielding an issue?打压植骨标准长度肱骨组件在全肩关节和扩髓型关节置换中的放射学结果:是否存在应力遮挡问题?
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Return to Sport Following Hemiarthroplasty With Concentric Reaming Versus Total Shoulder Arthroplasty: A Matched Pair Analysis.半关节置换术采用同心扩髓与全肩关节置换术后恢复运动:配对分析
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Ream and run and total shoulder: patient and shoulder characteristics in five hundred forty-four concurrent cases.扩髓打压植骨与全肩关节置换:544 例同期病例的患者和肩关节特点。
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