Management of Glenoid Bone Loss in Primary Reverse Total Shoulder Arthroplasty.

IF 2.9 2区 医学 Q1 ORTHOPEDICS Current Reviews in Musculoskeletal Medicine Pub Date : 2023-08-01 DOI:10.1007/s12178-023-09845-z
Nabil Mehta, Gregory P Nicholson
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Abstract

Purpose of review: Glenoid bone loss presents distinct challenges in reverse total shoulder arthroplasty (rTSA) which, if unaddressed, can cause complications including poor outcomes and early implant failure. The purpose of this review is to discuss the etiology, evaluation, and management strategies of glenoid bone loss in primary rTSA.

Recent findings: Three-dimensional computed tomography (3D CT) imaging and preoperative planning software have revolutionized the understanding of complex glenoid deformity and wear patterns from bone loss. With this knowledge, a detailed preoperative plan can be created and implemented for a more optimal management strategy. When appropriately indicated, deformity correction techniques with biologic or metal augmentation are successful in addressing the glenoid bone deficiency, creating optimal implant position, and thus providing stable baseplate fixation and improving outcomes. Thorough evaluation and characterization of the degree of glenoid deformity with 3D CT imaging is necessary prior to treatment with rTSA. Eccentric reaming, bone grafting, and augmented glenoid components have shown promising results in correcting glenoid deformity due to bone loss, but long-term outcomes are currently unknown.

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初次逆行全肩关节置换术中肩关节骨丢失的处理。
回顾目的:肩关节盂骨丢失是逆行全肩关节置换术(rTSA)中明显的挑战,如果不加以解决,可能导致并发症,包括预后不良和早期植入失败。本综述的目的是讨论原发性rTSA中盂骨丢失的病因、评估和管理策略。最近发现:三维计算机断层扫描(3D CT)成像和术前计划软件已经彻底改变了对复杂的肩关节畸形和骨质流失造成的磨损模式的理解。有了这些知识,就可以制定详细的术前计划,并实施更优化的管理策略。在适当的情况下,生物或金属隆胸的畸形矫正技术可以成功地解决关节盂骨缺损,创造最佳的植入物位置,从而提供稳定的底板固定和改善预后。在rTSA治疗之前,有必要通过3D CT成像对关节盂畸形程度进行全面评估和表征。偏心扩孔、植骨和增强盂骨假体在纠正骨质丢失引起的盂骨畸形方面显示出有希望的结果,但长期结果目前尚不清楚。
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来源期刊
CiteScore
7.50
自引率
2.40%
发文量
64
期刊介绍: This journal intends to review the most significant recent developments in the field of musculoskeletal medicine. By providing clear, insightful, balanced contributions by expert world-renowned authors, the journal aims to serve all those involved in the diagnosis, treatment, management, and prevention of musculoskeletal-related conditions. We accomplish this aim by appointing authorities to serve as Section Editors in key subject areas, such as rehabilitation of the knee and hip, sports medicine, trauma, pediatrics, health policy, customization in arthroplasty, and rheumatology. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known figures in the field, and an Editorial Board of more than 20 diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.
期刊最新文献
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