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作 者:Claudio Chillemi Carlo Paglialunga Greta De Giorgi Riccardo Proietti Stefano Carli Marco Damo
机构地区:[1]Department of Orthopaedics and Traumatology,Istituto Chirurgico Ortopedico Traumatologico,Latina 04100,Lazio,Italy [2]Department of Anatomical,Histological,Forensic Medicine and Orthopaedics Sciences,Sapienza University of Rome,ICOT,Latina 04100,Lazio,Italy
出 处:《World Journal of Orthopedics》2021年第6期403-411,共9页世界骨科杂志(英文版)
摘 要:BACKGROUND Glenohumeral osteoarthritis(OA)is a common cause of pain and disability affecting nearly a third of the world’s population over 60 years of age.As in other joints,shoulder arthroplasty appears to be the most effective treatment.The implant design has evolved during time transitioning to shorter humeral stem lengths or even stemless components.AIM To evaluate the medium-term outcome and survival of a cementless humeral head resurfacing(HHR)in a group of patients affected with OA or avascular necrosis.METHODS This is a retrospective study of prospectively collected data using HHR in 23 patients(15 female and 8 male)after a 7.4 year follow-up.The collected data included clinical and radiographical evaluation.The Constant score,the visual analogue scale,and a clinical evaluation of range of motion were registered preand postoperatively.Fifteen patients affected with OA(2 cases of mild,6 moderate,and 7 severe)and 10 with avascular necrosis(stage III according to Cruess classification)were enrolled.X-rays were evaluated to detect loosening signs,degenerative changes,and superior humeral head migration.Magnetic resonance preoperatively was also performed to assess the rotator cuff status.Tendon integrity was mandatory to implant the HHR.RESULTS In total,19 patients(21 shoulders)completed the follow-up.Data on 4 shoulders,in 4 patients,were lost because of prosthesis failure.The global revision rate was 16%.A statistically significant improvement in the mean Constant score,visual analogue scale,and range of motion have been reported.No signs of loosening were registered,while in 12 cases a glenoid erosion was found.The osteophytes appeared 7 times on the humeral side and 12 on the glenoid.Superior humeral migration was recorded in only 1 case.CONCLUSION HHR remains a reasonable option in patients with an intact rotator cuff for the treatment of OA and avascular necrosis.
关 键 词:SHOULDER ARTHROPLASTY Humeral head RESURFACING Glenoid erosion Prosthesis failure
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