目的:反向肩关节假体越来越多地用于治疗肩袖撕裂性关节病和其他退行性肩关节疾病。近年来,为了保存骨骼材料,设计了没有干的干干phy端肱骨组件。这项研究的目的是评估并发症和再干预率,以及使用无柄植入物进行反向肩关节置换术(RSA)的患者的临床和影像学结局。
方法:使用PubMed完成了对文献的系统回顾,直到2020年5月,EMBASE,CINAHL和Cochrane数据库,根据PRISMA指南。
结果:文献检索显示2942项研究,其中13项包括在本次审查中,共517例患者,平均随访6.4至101.6个月。总并发症发生率为6.5%,3.3%为肱骨相关并发症。最后,接受再干预的肩膀率为6.7%,1.4%与肱骨部件有关。无茎RSA导致所有研究中患者报告的结果指标和运动范围的实质性改善。据报道,肩胛骨缺口占15.2%,据报道,肱骨周围的透明度占肩关节的0.8%。
结论:无茎RSA导致中期随访时并发症和再干预率低。报告的临床和放射学结果表明,这些假体与茎状假体至少具有相同的结果。需要进一步的研究来研究无茎肱骨植入物的长期寿命和性能。
方法:IV级;系统评价。
OBJECTIVE: Reverse shoulder prostheses are increasingly used for treatment of rotator cuff tear arthropathy and other degenerative shoulder diseases. In recent years, aiming for bone stock preservation has led to the design of metaphyseal humeral components without a stem. The aims of this study were to evaluate the complication and reintervention rates, as well as the clinical and radiographic outcomes in patients who underwent reverse shoulder arthroplasty (RSA) with
stemless implants.
METHODS: A systematic
review of the literature was completed until May 2020 using PubMed, EMBASE, CINAHL and Cochrane databases, according to PRISMA guidelines.
RESULTS: The literature search revealed 2942 studies, of which 13 were included in this
review, with a total of 517 patients and a mean follow-up between 6.4 and 101.6 months. The total complication rate was 6.5%, while 3.3% were humeral associated complications. Finally, the rate of shoulders that underwent a reintervention was 6.7%, with 1.4% relating to a humeral component reason.
Stemless RSA led to substantial improvements in patient reported outcome measures and range of motion across all studies. Scapular notching was reported in 15.2%, and lucencies around humeral component were reported in 0.8% of shoulders.
CONCLUSIONS: Stemless RSA resulted in low complication and reintervention rates at the mid-term follow-up. The reported clinical and radiological outcomes showed that these prostheses have at least equivalent outcomes with their stemmed counterparts. Further studies are required to investigate the long-term longevity and performance of the stemless humeral implants.
METHODS: Level IV; Systematic
Review.