PDF(Pubmed)
Abstract：
UNASSIGNED: Historically, Metal-Backed (MB) glenoid components in anatomical total Shoulder arthroplasty (aTSA) are prone to failure primarily due to loosening between the metal and bony surface. However, newer generations of MB glenoid components have performed well in reverse shoulder arthroplasty (RSA), with convertibility being considered to be the most significant benefit of MB components. Theoretically, MB components may be a viable option in \"Rotator cuff at risk\" cases. The aim of this study is to compare revisions versus revision-free survivorship and highlight problems associated with using convertible MB glenoid components in aTSA.
UNASSIGNED: Between December 2015 and September 2018, aTSA was performed on 30 patients utilizing 32 implants with convertible MB glenoid (two patients were operated bilaterally). The first investigation was performed at a mean of 55.9 months (43-76) by search in the national registry for revisions with twelve cases. The second FU on all remaining patients without revisions was conducted at a mean of 54.9 months (46-71) through physical examination with fourteen patients (sixteen implants), with four patients missing. Demographic data, indications, complications, revisions, and re-operations were recorded for each patient.
UNASSIGNED: High rates of complications led to revisions or re-operation in aTSA in combination with MB (15/32). Seven problems were associated with polyethylene (PE), which included loosening, disengagement, or wear. Eight complications were not directly associated with the MB component. There was one with loosening on the metal-bone interface side. Conversion to RSA was possible in three cases, and secondary cuff failure was seen once. High infection rates (2/32) led to a different strategy for antibiotics and preoperative preparations.
UNASSIGNED: MB glenoid components caused unacceptably high complication and revision rates in aTSA. PE wear, disengagement, or loosening were the main reasons for revisions. Therefore, procedures with MB glenoid components were abandoned in aTSA.
UNASSIGNED: Level IV case series, treatment study.
UNASSIGNED: Between December 2015 and September 2018, aTSA was performed on 30 patients utilizing 32 implants with convertible MB glenoid (two patients were operated bilaterally). The first investigation was performed at a mean of 55.9 months (43-76) by search in the national registry for revisions with twelve cases. The second FU on all remaining patients without revisions was conducted at a mean of 54.9 months (46-71) through physical examination with fourteen patients (sixteen implants), with four patients missing. Demographic data, indications, complications, revisions, and re-operations were recorded for each patient.
UNASSIGNED: High rates of complications led to revisions or re-operation in aTSA in combination with MB (15/32). Seven problems were associated with polyethylene (PE), which included loosening, disengagement, or wear. Eight complications were not directly associated with the MB component. There was one with loosening on the metal-bone interface side. Conversion to RSA was possible in three cases, and secondary cuff failure was seen once. High infection rates (2/32) led to a different strategy for antibiotics and preoperative preparations.
UNASSIGNED: MB glenoid components caused unacceptably high complication and revision rates in aTSA. PE wear, disengagement, or loosening were the main reasons for revisions. Therefore, procedures with MB glenoid components were abandoned in aTSA.
UNASSIGNED: Level IV case series, treatment study.
摘要：
■历史上，解剖全肩关节成形术（aTSA）中的金属背（MB）关节盂组件易于失效，主要是由于金属和骨表面之间的松动。然而,新一代MB关节盂组件在反向肩关节置换术(RSA)中表现良好，可兑换性被认为是MB组件的最显著优势。理论上,MB组件可能是“肩袖风险”案例中的可行选择。这项研究的目的是比较修订和无修订生存，并强调与在aTSA中使用可转换MB关节盂组件相关的问题。
■在2015年12月至2018年9月之间，对30例患者进行了aTSA，这些患者使用了32个带有可转换MB关节盂的植入物（两名患者进行了双侧手术）。第一次调查平均进行了55.9个月（43-76），通过在国家注册表中搜索12例病例的修订。通过对14名患者（16个植入物）的体格检查，平均54.9个月（46-71）对所有剩余患者进行了第二次FU，四个病人失踪了.人口统计数据,适应症,并发症,修订,并记录每位患者的再次手术情况。
■高并发症率导致aTSA合并MB的修正或再次手术（15/32）。七个问题与聚乙烯（PE）有关，其中包括松动，脱离接触,或穿。八种并发症与MB成分没有直接关系。金属-骨界面侧出现松动。在三种情况下转化为RSA是可能的，和继发性袖带衰竭见过一次。高感染率（2/32）导致抗生素和术前准备的不同策略。
■MB关节盂组件在aTSA中引起了不可接受的高并发症和翻修率。PE磨损,脱离接触,或松动是修改的主要原因。因此,在aTSA中放弃了使用MB关节盂组件的程序。
■IV级案例系列，治疗研究。
■在2015年12月至2018年9月之间，对30例患者进行了aTSA，这些患者使用了32个带有可转换MB关节盂的植入物（两名患者进行了双侧手术）。第一次调查平均进行了55.9个月（43-76），通过在国家注册表中搜索12例病例的修订。通过对14名患者（16个植入物）的体格检查，平均54.9个月（46-71）对所有剩余患者进行了第二次FU，四个病人失踪了.人口统计数据,适应症,并发症,修订,并记录每位患者的再次手术情况。
■高并发症率导致aTSA合并MB的修正或再次手术（15/32）。七个问题与聚乙烯（PE）有关，其中包括松动，脱离接触,或穿。八种并发症与MB成分没有直接关系。金属-骨界面侧出现松动。在三种情况下转化为RSA是可能的，和继发性袖带衰竭见过一次。高感染率（2/32）导致抗生素和术前准备的不同策略。
■MB关节盂组件在aTSA中引起了不可接受的高并发症和翻修率。PE磨损,脱离接触,或松动是修改的主要原因。因此,在aTSA中放弃了使用MB关节盂组件的程序。
■IV级案例系列，治疗研究。
