Comparing revision rates and survival of pyrocarbon and non-pyrocarbon heads in total shoulder and hemi-shoulder arthroplasty

IF 2.9 2区医学 Q1 ORTHOPEDICS Journal of Shoulder and Elbow Surgery Pub Date : 2025-04-01 Epub Date: 2024-09-05 DOI:10.1016/j.jse.2024.07.028

Dirk P.M. Douven MSc , Gert-Jan P. Geijsen MD , Paulien M. van Kampen PhD , Stefan A.F. Heijnen MD

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Abstract

Objective

This retrospective, observational study aimed to assess the revision rates and survival curves in total shoulder arthroplasty (TSA) and hemi-shoulder arthroplasty (HSA) patients, including a subanalysis to investigate the impact of a pyrocarbon humeral head in revision rates.

Methods

Data collected from 7 surgeons who performed primary HSA in 92 patients and primary TSA in 508 patients at a large private clinic were analyzed. The study focused on revision rates and identified factors leading to revisions, including rotator cuff insufficiency, dislocation, aseptic loosening, implant material, and glenoid erosion.

Results

The overall revision rate for HSA was found to be significantly higher (7.6%) than that for TSA (1.2%), with a maximum follow-up of 7 years. Subanalysis within the HSA group revealed a notably higher revision rate in cases involving a metal head (cobalt-chrome or titanium) (12.8%) than those with a pyrocarbon head (2.3%).

Conclusions

This study underscores the importance of distinguishing between TSA and HSA when evaluating shoulder arthroplasty outcomes. The significantly higher revision rate in HSA, particularly with metal heads, suggests the need for careful consideration of implant selection to optimize long-term success in shoulder arthroplasty procedures.

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比较全肩关节置换术和半肩关节置换术中热碳头和非热碳头的翻修率和存活率。

研究目的这项回顾性观察研究旨在评估全肩关节置换术（TSA）和半肩关节置换术（HSA）患者的翻修率和存活率曲线，包括一项子分析，以调查热碳肱骨头对翻修率的影响：分析了一家大型私人诊所的七位外科医生为 92 名初次 HSA 和 508 名初次 TSA 患者实施手术的数据。研究重点是翻修率，并确定了导致翻修的因素，包括肩袖功能不全、脱位、无菌性松动、植入物材料和盂侵蚀：结果发现，在最长七年的随访中，HSA的总体翻修率为7.6%，明显高于TSA的1.2%。HSA组内的子分析显示，金属头（钴铬合金或钛合金）病例的翻修率为12.8%，明显高于热碳头病例（2.3%）：本研究强调了在评估肩关节置换术结果时区分TSA和HSA的重要性。HSA的翻修率明显较高，尤其是使用金属头的患者，这表明需要仔细考虑植入物的选择，以优化肩关节成形术的长期成功率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Shoulder and Elbow Surgery 医学-外科

CiteScore

6.50

自引率

23.30%

发文量

604

审稿时长

11.2 weeks

期刊介绍： The official publication for eight leading specialty organizations, this authoritative journal is the only publication to focus exclusively on medical, surgical, and physical techniques for treating injury/disease of the upper extremity, including the shoulder girdle, arm, and elbow. Clinically oriented and peer-reviewed, the Journal provides an international forum for the exchange of information on new techniques, instruments, and materials. Journal of Shoulder and Elbow Surgery features vivid photos, professional illustrations, and explicit diagrams that demonstrate surgical approaches and depict implant devices. Topics covered include fractures, dislocations, diseases and injuries of the rotator cuff, imaging techniques, arthritis, arthroscopy, arthroplasty, and rehabilitation.