UNASSIGNED: A literature search was conducted using PubMed, Embase, and Medline. Patients who underwent a joint-preserving surgical procedure to treat a focal chondral defect of the glenoid, humeral head or both were included. Patients treated for diffuse cartilage defects or with shoulder arthroplasty were excluded.
UNASSIGNED: Ten studies were included, with follow-up data available for 194 shoulders. Eight joint-preserving procedures were evaluated, with microfracture being the most common. One study evaluating microfracture reported significant improvements in patient-reported outcomes at short-term and long-term follow-up compared to preoperative scores. Across all studies, 32 patients underwent subsequent shoulder surgery, with 22 being arthroplasties.
UNASSIGNED: We found improvements in patient-reported and functional outcomes across all studies. Although joint-preserving procedures have shown reasonable outcomes for focal chondral defects of the glenohumeral joint, long-term outcomes remain unknown, and the progression of osteoarthritis remains a concern. Higher quality evidence is required to make definitive recommendations.
UNASSIGNED: IV.
■使用PubMed进行了文献检索,Embase,Medline接受关节保留外科手术治疗关节盂局灶性软骨缺损的患者,肱骨头或两者都包括在内。排除接受弥漫性软骨缺损或肩关节置换术的患者。
■纳入了10项研究,有194个肩膀的随访数据。评估了八个关节保留程序,微骨折是最常见的。一项评估微骨折的研究报告,与术前评分相比,在短期和长期随访中,患者报告的预后显着改善。在所有研究中,32例患者接受了随后的肩部手术,22是关节置换术。
■我们发现所有研究的患者报告和功能结果都有改善。尽管保留关节的手术已显示出合理的结果,为盂肱骨关节的局灶性软骨缺损,长期结果仍然未知,骨关节炎的进展仍然令人担忧。提出明确的建议需要更高质量的证据。
■IV.