Cofield R H
Arch Surg. 1977 Sep;112(9):1088-91. doi: 10.1001/archsurg.1977.01370090070014.
Some patients with degenerative, rheumatoid, and traumatic diseases of the glenohumeral joint require treatment primarily to relieve pain. In the absence of complete knowledge of basic mechanical requirements, clinical trials with both constrained and resurfacing prosthesis were initiated. Three types of constrained prostheses were placed in 23 patients. Pain relief was satisfactory, but six reoperations were necessary and motion greater than 90 degrees was rarely achieved. Twenty-five prostheses that were used to replace the glenohumeral articulation, but were not stable by virtue of design, were implanted. Again, pain relief was excellent; mechanical problems were not present, and motion was almost always greater than 90 degrees. Achieving stability by capsular-muscle cuff repair has not been as great a problem as anticipated. These results suggest that more emphasis should be placed on repair of the glenohumeral stabilizing structures than on their replacement.
一些患有盂肱关节退行性、类风湿性和创伤性疾病的患者主要需要通过治疗来缓解疼痛。由于缺乏对基本力学要求的全面了解，于是开展了使用限制性假体和表面置换假体的临床试验。23例患者植入了三种类型的限制性假体。疼痛缓解效果令人满意，但需要进行6次再次手术，且很少能实现大于90度的活动度。植入了25个用于替换盂肱关节面但因设计原因不稳定的假体。同样，疼痛缓解效果极佳；不存在机械问题，且活动度几乎总是大于90度。通过修复关节囊 - 肌肉袖套来实现稳定性并没有预期的那么困难。这些结果表明，应更加强调修复盂肱关节稳定结构而非进行置换。
