PDF(Pubmed)
Abstract：
Reverse total shoulder arthroplasty (rTSA) is increasingly being used as a reliable option for various shoulder disorders with deteriorated rotator cuff and glenohumeral joints. The stemless humerus component for shoulder arthroplasties is evolving with theoretical advantages, such as preservation of the humeral bone stock and decreased risk of periprosthetic fractures, as well as clinical research demonstrating less intraoperative blood loss, reduced surgical time, a lower rate of intraoperative fractures, and improved center of rotation restoration. In particular, for anatomical total shoulder arthroplasty (aTSA), the utilization of stemless humeral implants is gaining consensus in younger patients. The current systematic review of 14 clinical studies (637 shoulders) demonstrated the clinical outcomes of stemless rTSA. Regarding shoulder function, the mean Constant-Murley Score (CS) improved from 28.3 preoperatively to 62.8 postoperatively. The pooled overall complication and revision rates were 14.3% and 6.3%, respectively. In addition, recent studies have shown satisfactory outcomes with stemless rTSA relative to stemmed rTSA. Therefore, shoulder surgeons may consider adopting stemless rTSA, especially in patients with sufficient bone quality. However, further long-term studies comparing survivorship between stemless and stemmed rTSA are required to determine the gold standard for selecting stemless rTSA.
摘要：
反向全肩关节置换术（rTSA）越来越多地用作各种肩关节疾病的可靠选择，肩袖和盂肱关节恶化。肩关节置换术的无茎肱骨组件正在以理论优势发展，如保存肱骨骨和降低假体周围骨折的风险，以及临床研究表明术中失血减少，减少手术时间，术中骨折的发生率较低，改善了旋转中心的恢复。特别是,用于解剖学全肩关节置换术（aTSA），在年轻患者中，无茎肱骨植入物的使用已获得共识。目前对14项临床研究（637项）的系统评价证明了无茎rTSA的临床结果。关于肩部功能，平均Constant-Murley评分（CS）从术前的28.3提高到术后的62.8。合并的总并发症和翻修率分别为14.3%和6.3%，分别。此外,最近的研究显示，与茎rTSA相比，无茎rTSA的结果令人满意。因此,肩部外科医生可能会考虑采用无茎rTSA，尤其是骨质量充足的患者。然而,需要进一步的长期研究比较无茎rTSA和有茎rTSA的存活率,以确定选择无茎rTSA的金标准.
