METHODS: We analyzed registry data from 696 CTA patients prospectively collected between 2012 and 2020 in two specialized orthopedic centers up to 2 years post-RSA with the same follow-up time points (6,12 24 months). Complete teres minor tears were excluded. Three groups were defined: group 1 (inlay, 155° humeral inclination, 36 + 2 mm eccentric glenosphere (n = 50)), group 2 (inlay, 135° humeral inclination, 36 + 4 mm lateralized glenosphere (n = 141)) and group 3 (onlay, 145° humeral inclination, + 3 mm lateralized base plate, 36 + 2 mm eccentric glenosphere (n = 35)) We compared group differences in clinical outcomes (e.g., active and passive range of motion (ROM), abduction strength, Constant-Murley score (CS)), radiographic evaluations of prosthetic position, scapular anatomy and complications using mixed models adjusted for age and sex.
RESULTS: The final analysis included 226 patients. The overall adjusted p-value of the CS for all time-points showed no significant difference (p = 0.466). Flexion of group 3 (mean, 155° (SD 13)) was higher than flexion of group 1 (mean, 142° (SD 18) and 2 (mean, 132° (SD 18) (p < 0.001). Values for abduction of group 3 (mean, 145° (SD 23)) were bigger than those of group 1 (mean, 130° (SD 22)) and group 2 (mean, 118° (SD 25)) (p < 0.001). Mean external rotation for group 3 (mean, 41° (SD 23)) and group 2 (mean, 38° (SD 17)) was larger than external rotation of group 1 (mean, 24° (SD 16)) (p < 0.001); a greater proportion of group 2 (78%) and 3 (69%) patients reached L3 level on internal rotation compared to group 1 (44%) (p = 0.003). Prosthesis position measurements were similar, but group 3 had significantly less scapular notching (14%) versus 24% (group 2) and 50% (group 1) (p = 0.001).
CONCLUSIONS: Outcome scores of different RSA designs for CTA revealed comparable results. However, CTA patients with a lateralized and distalized RSA configuration were associated with achieving better flexion and abduction with less scapular notching. A better rotation was associated with either of the lateralized RSA designs in comparison with the classic Grammont prosthesis.
METHODS: Therapeutic study, Level III.
方法:我们分析了2012年至2020年在两个专业骨科中心前瞻性收集的696名CTA患者的注册数据,随访时间点相同(6,12-24个月)。完全圆的轻微眼泪被排除。定义了三组:第1组(嵌体,肱骨倾角155°,36+2毫米偏心球球(n=50)),第2组(嵌体,肱骨倾角135°,36+4毫米的侧向关节盂球(n=141)和第3组(高嵌体,肱骨倾角145°,+3mm侧向底板,36+2毫米偏心性腺球(n=35)我们比较了临床结果的组间差异(例如,主动和被动运动范围(ROM),绑架强度,Constant-Murley得分(CS)),假体位置的射线照相评估,使用根据年龄和性别调整的混合模型的肩胛骨解剖结构和并发症。
结果:最终分析包括226名患者。所有时间点的CS的总体调整p值没有显着差异(p=0.466)。第3组的屈曲(平均,155°(SD13))高于第1组的屈曲(平均值,142°(SD18)和2(平均值,132°(SD18)(p<0.001)。第3组外展值(平均值,145°(SD23))大于第1组(平均值,130°(SD22)和第2组(平均值,118°(SD25))(p<0.001)。第3组的平均外部旋转(平均值,41°(SD23)和第2组(平均值,38°(SD17))大于第1组的外部旋转(平均值,24°(SD16))(p<0.001);与第1组(44%)相比,第2组(78%)和3组(69%)患者在内部旋转时达到L3水平的比例更大(p=0.003)。假体位置测量相似,但第3组的肩胛骨切口(14%)明显少于24%(第2组)和50%(第1组)(p=0.001).
结论:CTA的不同RSA设计的结果评分显示出相当的结果。然而,具有横向和远端RSA构型的CTA患者与获得更好的屈曲和外展相关,肩胛骨切口较少。与经典的Grammont假体相比,任何一种侧向RSA设计都具有更好的旋转。
方法:治疗性研究,三级。