Roelker Leandra, Ghasemi Ali, Fabregas Andrea, Shaffer Gene, Raphael James
Orthopaedics, Drexel University College of Medicine, Philadelphia, USA.
Orthopaedic Surgery, Einstein Healthcare Network, Philadelphia, USA.
Cureus. 2025 Jul 26;17(7):e88813. doi: 10.7759/cureus.88813. eCollection 2025 Jul.
Glenohumeral arthritis is commonly managed by total shoulder arthroplasty (TSA), but risks of TSA failure due to its prosthetic glenoid component raise serious concerns, prompting some patients to turn to the ream and run technique (RnR) as an alternative procedure that avoids such complications. This systematic review and meta-analysis compared clinical outcomes of patients who underwent TSA or RnR treatment for glenohumeral arthritis. A total of 668 shoulders from a total of 666 patients were included, with 325 shoulders undergoing RnR and 343 shoulders undergoing TSA. Significant postoperative improvements in simple shoulder test (SST) score (RnR: 4.99, TSA: 4.51), American Shoulder and Elbow Surgeons (ASES) score (RnR: 40.50, TSA: 40.22), external rotation (RnR: 21.22º, TSA: 19.72º), and forward elevation (RnR: 24.75º, TSA: 40.50º) were found in both cohorts. A significant reduction in visual analog scale (VAS) pain score (RnR: -4.08, TSA: 3.93) was also found in both cohorts. Meta-analysis demonstrated no statistically significant difference between treatments across every outcome measure of the study. Both RnR and TSA techniques significantly improve pain and increase functionality and mobility in patients with glenohumeral arthritis. These findings have significant implications for clinical practice moving forward, as they offer clinicians and patients an additional treatment option with comparable outcomes.
肩肱关节关节炎通常通过全肩关节置换术（TSA）进行治疗，但由于其假体肩胛盂部件导致TSA失败的风险引发了严重担忧，促使一些患者转而采用扩髓并保留技术（RnR）作为一种避免此类并发症的替代手术。本系统评价和荟萃分析比较了接受TSA或RnR治疗肩肱关节关节炎患者的临床结果。共纳入666例患者的668个肩部，其中325个肩部接受RnR治疗，343个肩部接受TSA治疗。两个队列在术后简单肩关节试验（SST）评分（RnR：4.99，TSA：4.51）、美国肩肘外科医师学会（ASES）评分（RnR：40.50，TSA：40.22）、外旋（RnR：21.22°，TSA：19.72°）和前屈（RnR：24.75°，TSA：40.50°）方面均有显著改善。两个队列在视觉模拟量表（VAS）疼痛评分方面也有显著降低（RnR：-4.08，TSA：3.93）。荟萃分析表明，在该研究的各项结局指标中，两种治疗方法之间无统计学显著差异。RnR和TSA技术均能显著改善肩肱关节关节炎患者的疼痛，并提高其功能和活动度。这些发现对未来的临床实践具有重要意义，因为它们为临床医生和患者提供了一种具有可比疗效的额外治疗选择。
