Convertible-platform shoulder arthroplasty

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Abstract

Background

Shoulder arthroplasty has become an increasingly common procedure used to treat degenerative, inflammatory, and traumatic conditions of the glenohumeral joint. With a significant increase in primary anatomic and reverse total shoulder arthroplasty, revision procedures have likewise increased. Updates in shoulder arthroplasty have allowed for the convertibility of implants, which allows for the retention of both glenoid and humeral components during revision surgery. This review aims to highlight the epidemiology, indications, and outcomes of convertible-platform total shoulder arthroplasty procedures.

Methods

A review of the current literature surrounding convertible-platform shoulder arthroplasty was completed to highlight the advantages and disadvantages of commercially available instrumentation and implant systems as well as their outcomes.

Discussion

Leading causes of shoulder arthroplasty revision surgery include glenoid failure, implant instability, and rotator cuff dysfunction. Variations in implant design between inlay and onlay humeral components and metal-backed glenoid components are important considerations at the time of revision surgery. Advantages of convertible-platform systems include increased efficiency and decreased complications during revision procedures as well as shorter recovery, lower cost, and better functional outcomes. Limitations of convertible systems include poorly positioned components during the index procedure, excessive soft-tissue tensioning, and problems associated with metal-backed glenoid implants. Changes in arm length have also been documented. These findings indicate the benefit of additional research and design to improve the effectiveness and utility of convertible-platform shoulder arthroplasty systems.

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可转换平台肩关节置换术
背景肩关节置换术已成为治疗盂肱关节退行性病变、炎症和创伤性疾病的一种越来越常见的手术。随着初次解剖和反向全肩关节置换术的大幅增加,翻修手术也同样增加。肩关节置换术的更新使植入物可以转换,从而在翻修手术中可以保留盂和肱骨两部分。本综述旨在强调可转换平台全肩关节成形术的流行病学、适应症和疗效。讨论肩关节成形术翻修手术的主要原因包括盂成形失败、植入物不稳定和肩袖功能障碍。在进行翻修手术时,肱骨内嵌和外嵌组件以及金属支撑盂组件之间的植入物设计差异是重要的考虑因素。可转换平台系统的优点包括提高翻修手术的效率、减少并发症、缩短恢复期、降低成本和改善功能效果。可转换系统的局限性包括在指数手术中组件定位不佳、软组织张力过大以及与金属支撑盂状植入物相关的问题。臂长的变化也有记录在案。这些研究结果表明,为了提高可转换平台肩关节置换系统的有效性和实用性,还需要进行更多的研究和设计。
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审稿时长
6 weeks
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