Instability after reverse total shoulder replacement
Instability after reverse total shoulder replacement
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DOI：
10.1016/j.jse.2010.08.028
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发表时间：
2011-06-01
影响因子：
3
通讯作者：
Warren, Russell F.
中科院分区：
文献类型：
--
作者：
Gallo, Robert A.;Gamradt, Seth C.;Warren, Russell F.
背景：尽管在技术和假体设计方面取得了进步，反向全肩关节置换术后的不稳定性仍然是一个具有挑战性的术后并发症。材料和方法：我们研究了我们机构在3年内(2004-2006年)进行的57例反向全肩关节置换术。9例肩关节不稳，均发生在术后6个月内。结果：9例患者在初次逆行全肩关节置入术时均有肩袖下肌腱损伤。在种植体定位方面，2例上倾后凸，3例后凸上移。每名脱位患者至少接受一次翻修手术，4名患者有潜在感染。在最近的随访中，只有3例患者进行了向心性复位的逆行全肩关节置换术，3例患者保持外展，2例慢性脱位，1例慢性半脱位。结论：逆行全肩关节置换术后早期不稳定可能与软组织不足、三角肌张力不足、假体错位和/或感染有关，早期不稳定的治疗效果一般较差。证据水平：IV级，病例系列，治疗研究。(C)2011年《肩肘外科杂志》董事会成员。
Background: Despite advances in technique and implant design, instability after reverse total shoulder arthroplasty remains a challenging postoperative complication.Materials and methods: We examined our institutions' first 57 reverse total shoulder arthroplasties performed during a 3-year period (2004-2006). There were 9 cases of instability, all occurring within the first 6 months after surgery.Results: All 9 patients had compromise of the subscapularis tendon at the time of initial reverse total shoulder implantation. With regard to implant positioning, 2 patients had superiorly inclined metaglenes and 3 had metaglenes positioned superior to the inferior glenoid. Each patient with a dislocation had at least 1 revision surgery, and 4 patients had underlying infection. At most recent follow-up, only 3 patients had a concentrically reduced reverse total shoulder arthroplasty in place whereas 3 remained explanted, 2 chronically dislocated, and 1 chronically subluxated.Conclusions: Early instability after reverse total shoulder arthroplasty can be related to inadequate soft tissue, inadequate deltoid tension, malpositioned implants, and/or infection, and outcomes of treatment of early instability are generally poor.Level of evidence: Level IV, Case Series, Treatment Study. (C) 2011 Journal of Shoulder and Elbow Surgery Board of Trustees.