定制肩关节假体在反向全肩关节置换术中的应用。

IF 1.8 Q2 ORTHOPEDICS Clinics in Shoulder and Elbow Pub Date : 2023-12-01 Epub Date: 2023-11-14 DOI:10.5397/cise.2023.00563
Punyawat Apiwatanakul, Prashant Meshram, Andrew B Harris, Joel Bervell, Piotr Łukasiewicz, Ridge Maxson, Matthew J Best, Edward G McFarland
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引用次数: 0

摘要

背景:本研究的目的是评估使用定制的反向肩关节置换盂底钢板治疗严重盂底不足,并强调该方法的挑战,包括短期临床和影像学结果以及短期并发症。方法:这是一个单一机构的回顾性病例系列,包括2017年1月至2022年12月期间的29例患者,他们为广泛的盂骨骨丢失创建了定制的盂骨假体。患者术前和每隔5年进行评估。所有患者术前均接受体格检查、x线平片和计算机断层扫描(CT)。定制的植入物是由制造商的工程师计划和制造的。报告了手术内和术后并发症。结果:在29例患者中,只有25例延迟接受手术,其中3例植入物与关节盂不匹配。对于这三个人来说,从他们的CT扫描到植入平均需要7.6个月(范围,6.1-10.7个月),相比之下,那些植入没有困难的人需要5.5个月(范围,2-8.6个月)。在随访至少2年的患者中(n=9),没有发生失败。在这9名患者中,所有患者报告的预后指标均有显著改善(美国肩肘评分,p)。结论:在本研究中,从CT扫描到植入器械的时间延长(bbb6个月)导致骨丢失,导致植入物无法使用。使用合适的设备,至少2年后可以获得满意的短期放射学和临床随访。
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Use of custom glenoid components for reverse total shoulder arthroplasty.

Background: Our purpose was to evaluate a custom reverse total shoulder arthroplasty glenoid baseplate for severe glenoid deficiency, emphasizing the challenges with this approach, including short-term clinical and radiographic outcomes and complications.

Methods: This was a single-institution, retrospective series of 29 patients between January 2017 and December 2022 for whom a custom glenoid component was created for extensive glenoid bone loss. Patients were evaluated preoperatively and at intervals for up to 5 years. All received preoperative physical examinations, plain radiographs, and computed tomography (CT). Intra- and postoperative complications are reported.

Results: Of 29 patients, delays resulted in only undergoing surgery, and in three of those, the implant did not match the glenoid. For those three, the time from CT scan to implantation averaged 7.6 months (range, 6.1-10.7 months), compared with 5.5 months (range, 2-8.6 months) for those whose implants fit. In patients with at least 2-year follow-up (n=9), no failures occurred. Significant improvements were observed in all patient-reported outcome measures in those nine patients (American Shoulder and Elbow Score, P<0.01; Simple Shoulder Test, P=0.02; Single Assessment Numeric Evaluation, P<0.01; Western Ontario Osteoarthritis of the Shoulder Index, P<0.01). Range of motion improved for forward flexion and abduction (P=0.03 for both) and internal rotation up the back (P=0.02). Pain and satisfaction also improved (P<0.01 for both).

Conclusions: Prolonged time (>6 months) from CT scan to device implantation resulted in bone loss that rendered the implants unusable. Satisfactory short-term radiographic and clinical follow-up can be achieved with a well-fitting device. Level of evidence: III.

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来源期刊
CiteScore
0.30
自引率
0.00%
发文量
55
审稿时长
15 weeks
期刊最新文献
The radiographic and clinical outcomes of stemless reverse total shoulder arthroplasty: a minimum 2-year follow-up study. Reconstruction of chronic long head of biceps tendon tears with gracilis allograft: report of two cases. Surgical management of biconcave glenoids: a scoping review. Surgical anatomical landmarks for arthroscopic repair of subscapularis tendon tears. Experiences and outcomes in shoulder replacements in a district general hospital over 19 years.
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