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在反肩关节置换术中常规使用定制器械可显著改善关节盂部件的倾斜角度。

Routine use of patient specific instruments in reverse shoulder arthroplasty produces significant improvements in the inclination profile of the glenoid component.

作者信息

Lee George, Dudin Walid, Assiotis Angelos, Rumian Adam, Yeoh Clarence, Soogumbur Akash, Sahota Simran, Uppal Harpal

机构信息

East and North Hertfordshire NHS Trust, Trauma and Orthopaedic Department, Lister Hospital, Stevenage, UK.

出版信息

Shoulder Elbow. 2025 Sep 12:17585732251371304. doi: 10.1177/17585732251371304.

Abstract

INTRODUCTION

The outcome of reverse shoulder arthroplasty (RSA) is strongly correlated to the accuracy of implantation, particularly with regard to inclination of the glenoid component. 3D planning has become more prevalent and with this has come the development of patient-specific instruments (PSI). In our centre, since 2019, all elective RSAs have been planned with a 3D printed PSI. We hypothesised that PSI has improved the inclination of the glenoid component since its introduction.

METHODOLOGY

Retrospective analysis identified 50 elective RSAs pre and post the use of PSI. Post-operative radiographs were assessed in the anterior-posterior orientation to identify an inclination angle by two investigators.

FINDINGS

The interrater reliability (ICC 3K) between the two investigators was 0.960 (CI 0.94-0.97). The mean inclination of the none PSI group was +7.53° (SD ±14.31) while the mean inclination of the PSI group was +2.95° (SD ±7.82) ( = 0.0498).

CONCLUSION

This study demonstrates that routine use of an additional intra-operative adjunct, such as a PSI jig for all cases of RSA should be considered, to improve the ability of the surgeon to reproduce the surgical plan faithfully.

摘要

引言

反肩关节置换术(RSA)的结果与植入的准确性密切相关,特别是在关节盂组件的倾斜度方面。三维规划已变得更加普遍,随之而来的是定制患者器械(PSI)的发展。在我们中心,自2019年以来,所有择期RSA手术都采用三维打印的PSI进行规划。我们假设自引入PSI以来,它改善了关节盂组件的倾斜度。

方法

回顾性分析确定了50例在使用PSI前后进行的择期RSA手术。由两名研究人员对术后前后位X线片进行评估,以确定倾斜角度。

结果

两名研究人员之间的组内相关系数(ICC 3K)为0.960(可信区间0.94 - 0.97)。非PSI组的平均倾斜度为+7.53°(标准差±14.31),而PSI组的平均倾斜度为+2.95°(标准差±7.82)(P = 0.0498)。

结论

本研究表明,应考虑对所有RSA病例常规使用额外的术中辅助工具(如PSI夹具),以提高外科医生忠实地再现手术计划的能力。

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