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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.

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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