Reverse total shoulder arthroplasty
Reverse total shoulder arthroplasty
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DOI：
10.1302/2058-5241.3.170044
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发表时间：
2018-02-01
影响因子：
3.4
通讯作者：
McFarland, Edward G.
中科院分区：
文献类型：
--
作者：
Familiari, Filippo;Rojas, Jorge;McFarland, Edward G.
自1987年引入反向全肩关节置换术（RTSA）以来，（欧洲）和2004年尽管RTSA的主要适应症是肩袖撕裂，但适应症已经扩展到包括几种肩部疾病，其中许多涉及肩袖功能障碍。据报道，RTSA并发症影响19%至68%的患者，包括肩峰骨折、血肿、感染、不稳定、机械基板失效，神经损伤、假体周围骨折和肩胛骨切迹。目前RTSA的争议包括最佳基板定位、肱骨颈干角（135度与155度）、肩盂球放置（内侧、外侧或骨增加偏移RTSA）和肩胛下肌修复。需要改进假体设计、外科医生经验和临床结果，以优化许多肩部疾病的治疗。
Since the introduction of reverse total shoulder arthroplasty (RTSA) in 1987 (in Europe) and 2004 (in the United States), the number of RTSAs performed annually has increased.Although the main indication for RTSA has been rotator cuff tears, indications have expanded to include several shoulder conditions, many of which involve dysfunction of the rotator cuff.RTSA complications have been reported to affect 19% to 68% of patients and include acromial fracture, haematoma, infection, instability, mechanical baseplate failure, neurological injury, periprosthetic fracture and scapular notching.Current controversies in RTSA include optimal baseplate positioning, humeral neck-shaft angle (135 degrees versus 155 degrees), glenosphere placement (medial, lateral or bony increased offset RTSA) and subscapularis repair.Improvements in prosthesis design, surgeon experience and clinical results will need to occur to optimize this treatment for many shoulder conditions.