Can a functional difference be detected in reverse arthroplasty with 135° versus 155° prosthesis for the treatment of rotator cuff arthropathy: a prospective randomized study
Can a functional difference be detected in reverse arthroplasty with 135° versus 155° prosthesis for the treatment of rotator cuff arthropathy: a prospective randomized study
复制标题
DOI：
10.1016/j.jse.2018.11.064
复制
发表时间：
2019-05-01
影响因子：
3
通讯作者：
Denard, Patrick J.
中科院分区：
文献类型：
--
作者：
Gobezie, Reuben;Shishani, Yousef;Denard, Patrick J.
背景：这项随机对照试验的目的是比较接受初次反向肩关节置换术 (RSA) 的患者的 135 度和 155 度肱骨倾斜度。我们的假设是，155 度组的前屈程度较高，但与肩胛骨切迹率较高相关。方法：对 100 例肱骨倾斜度为 135 度或 155 度的原发性 RSA 进行随机对照试验。假体在其他方面是相同的，并且在所有情况下都使用中性盂球。术后至少 2 年评估功能结果、前屈、外旋和肩胛切迹。结果：两组之间的运动范围或功能结果评分没有差异。在 155 度组中，前屈从 76 度改善到 135 度 (P < .001)，外旋保持不变（29 度与 30 度；P = .835）。在 135 度组中，术后前屈从 78 度改善至 132 度 (P < .001)，外旋度保持不变（28 度与 29 度；P = .814）。 155 度倾斜的病例中有 58% 观察到肩胛切迹，而 135 度倾斜的病例为 21% (P = .009)。结论：对于中性盂球，肱骨倾斜 135 度与 155 度的 RSA 术后前屈或外旋没有差异。与 155 度设计相比，使用 135 度设计减少了肩胛切迹，但在没有侧化盂球的情况下，在 2 年随访中，肩胛切迹仍保持在 21%。 (C) 2018 年肩肘外科杂志董事会。版权所有。
Background: The purpose of this randomized controlled trial was to compare humeral inclinations of 135 degrees and 155 degrees in patients undergoing primary reverse shoulder arthroplasty (RSA). Our hypothesis was that forward flexion would be higher in the 155 degrees group but be associated with a higher rate of scapular notching.Methods: A randomized controlled trial was conducted on 100 primary RSAs performed with a humeral inclination of either 135 degrees or 155 degrees. The prostheses were otherwise identical and a neutral glenosphere was used in all cases. Functional outcome, forward flexion, external rotation, and scapular notching were assessed at a minimum of 2 years postoperatively.Results: There was no difference in range of motion or functional outcome scores between the 2 groups. In the 155 degrees group, forward flexion improved from 76 degrees to 135 degrees (P < .001) and external rotation remained unchanged (29 degrees vs. 30 degrees; P = .835). In the 135 degrees group, postoperative forward flexion improved from 78 degrees to 132 degrees (P < .001) and external rotation was unchanged (28 degrees vs. 29 degrees; P = .814). Scapular notching was observed in 58% of cases with a 155 degrees inclination compared with 21% with a 135 degrees inclination (P = .009).Conclusion: With a neutral glenosphere there was no difference in postoperative forward flexion or external rotation after an RSA with a humeral inclination of 135 degrees compared with 155 degrees. Scapular notching was reduced with the use of 135 degrees design compared with a 155 degrees design but persists at a rate of 21% at 2-year follow-up in the absence of a lateralized glenosphere. (C) 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.