Fahad A Nadeem, Caleb V Hayes, James R Jones, Mathew D Hargreaves, Eugene W Brabston, Aaron J Casp, Amit M Momaya, Thomas B Evely
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引用次数: 0
摘要
简介随着时间的推移，肩关节置换术的发病率越来越高。肩关节置换术后的潜在并发症之一是异位骨化（HO），即骨骼外骨在软组织中的异常生长，这种并发症的研究并不深入。在全髋关节置换术文献中，异位骨化已被描述为一种并发症，但在肩关节置换术中却鲜有描述。本系统性综述旨在提供有关肩关节置换术后 HO 的发生率、风险因素和潜在处理方法的现有证据：方法：2023 年 6 月，我们使用 Pubmed、Embase 和 Ovid Medline 数据库进行了系统性检索，检索了所有评估肩关节置换术后 HO 发生率的相关研究。检索一式两份，并对所有研究进行了质量评估：结果：共检索到 170 项研究，其中 6 项被纳入，涉及 1,028 名接受肩关节置换术的患者和 1,038 个接受手术的肩部。在纳入的研究中，28%的肩关节置换术后出现HO，12%的肩关节置换术后出现症状，大多数病例发生在出现骨关节炎和肩袖撕裂关节病的肩关节。男性在肩关节置换术后患 HO 的风险似乎更高。只有不到2%的HO肩患者接受了翻修手术，非HO肩和HO肩的术后平均抬高角度和外旋角度没有明显差异。此外，使用非甾体类抗炎药对肩关节置换术后HO的形成没有益处：结论：在我们的研究中，28%的肩关节置换术后会出现HO。结论：在我们的综述中，28%的肩关节置换术患者会出现HO，其中大部分患者没有症状。男性患者以及接受过骨关节炎翻修手术和肩袖撕裂关节置换术的患者在肩关节置换术后发生HO的风险似乎更高。非甾体类抗炎药似乎不能预防肩关节置换术后HO的发生，但这一说法还需要未来的研究来验证：证据等级：III级；系统综述。
Heterotopic Ossification After Shoulder Arthroplasty: A Systematic Review.
Introduction: Shoulder arthroplasty is increasing in incidence over time. One potential complication that is not well studied following shoulder arthroplasty is heterotopic ossification (HO), the abnormal growth of extraskeletal bone in soft tissue. HO has been described as a complication in total hip arthroplasty literature but less described in the setting of shoulder arthroplasty. The aim of this systematic review is to present available evidence regarding the incidence, risk factors, and potential management of HO after shoulder arthroplasty.
Methods: A systematic search was conducted in June 2023 using Pubmed, Embase, and Ovid Medline databases to retrieve all relevant studies evaluating the occurrence of HO after shoulder arthroplasty. The search was done in duplicate, and a quality assessment of all studies was included.
Results: A total of 170 studies were retrieved, of which 6 were included, involving 1,028 patients undergoing shoulder arthroplasty with 1,038 operated shoulders. HO developed postoperatively in 28% of the included shoulders and was symptomatic in 12% with most cases occurring in shoulders that developed osteoarthritis and cuff tear arthropathy. Men appear to have an increased risk of developing HO post shoulder arthroplasty. Fewer than 2% of HO shoulders went on to have revision surgery, and no notable differences were observed in the postoperative mean elevation and external rotation angles of non-HO and HO shoulders. In addition, no reported benefit of the use of nonsteroidal anti-inflammatory drugs was found against the formation of HO after shoulder arthroplasty.
Conclusion: HO occurs in 28% of shoulder arthroplasties in our review. Most of these were asymptomatic in the reviewed articles. Male patients and revision surgery with osteoarthritis and cuff tear arthroplasty seem to be at higher risk of developing HO post shoulder arthroplasty. Nonsteroidal anti-inflammatory drugs seem to not prevent the development of HO after shoulder arthroplasty; yet, future studies are needed to verify this claim.
期刊介绍：
The Journal of the American Academy of Orthopaedic Surgeons was established in the fall of 1993 by the Academy in response to its membership’s demand for a clinical review journal. Two issues were published the first year, followed by six issues yearly from 1994 through 2004. In September 2005, JAAOS began publishing monthly issues.
Each issue includes richly illustrated peer-reviewed articles focused on clinical diagnosis and management. Special features in each issue provide commentary on developments in pharmacotherapeutics, materials and techniques, and computer applications.
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