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首页> 外文期刊>Journal of shoulder and elbow surgery >Revision total shoulder arthroplasty for painful glenoid arthrosis after humeral head replacement: The nontraumatic shoulder
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Revision total shoulder arthroplasty for painful glenoid arthrosis after humeral head replacement: The nontraumatic shoulder

机译：修改肱骨头换下疼痛关节关节术治疗总肩部关节置换术：非创伤肩

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摘要

Background: Patients treated with humeral head replacement (HHR) may require revision to total shoulder arthroplasty (TSA) due to glenoid arthrosis. This study characterizes the outcomes of revision TSA in patients who initially underwent HHR for nontraumatic glenohumeral arthritis. Methods: From 1982 to 2005, 68 shoulders underwent revision TSA for glenoid arthrosis. The initial HHR was performed for non-fracture-related arthritis. Revisions were grouped according to complexity for analysis. Stem revision and soft tissue reconstruction were assessed in relation to outcome. Results: Pain scores decreased from 4.4 to 2.8, abduction increased from 85° to 116°, external rotation increased from 36° to 48°, and internal rotation remained unchanged. Survivorship free of repeat revision was 95.6%, 84.1%, and 72.9% at 1, 5, and 10 years. The Neer rating yielded 20 excellent, 10 satisfactory, and 38 unsatisfactory outcomes. No differences in motion, survivorship, or the Neer rating occurred between groups by procedure complexity. There was, however, less reduction in pain for the group requiring a humeral stem revision. Of the 9 shoulders with postoperative instability, 7 had compromised soft tissues preoperatively. Conclusions: Revision TSA after HHR results in decreased pain and increased motion. Result ratings, however, are quite variable and, in many cases, unsatisfactory. Stratification of the procedures according to complexity does not demonstrate differences in motion, satisfaction, or survivorship. Stem revision, however, results in reduced pain score improvement. Coexisting instability associated with subscapularis and anterior shoulder capsule damage may not be correctable using an unconstrained shoulder arthroplasty.
机译：背景：肱骨头部替换（HHR）治疗的患者可能需要修改由于关节环骨关节病引起的肩部关节置换术（TSA）。本研究表征了最初接受了非吸引性胶质蟾性关节炎的HHR患者的修订TSA的结果。方法：从1982年到2005年，68名肩膀接受关节关节的修订TSA。对非骨折相关的关节炎进行初始HHR。修订根据复杂性进行分组进行分析。茎修复和软组织重建是关于结果的评估。结果：疼痛评分从4.4降低到2.8，绑架从85°增加到116°，外旋转从36°增加到48°，内部旋转保持不变。救世主自由重复修订为95.6％，84.1％，可在1,5和10年内为72.9％。 Neer评级产生了20个优秀，10个令人满意，38个不令人满意的结果。通过程序复杂性在组之间发生差异，生存或NEER额定值没有差异。然而，对于需要肱骨干燥修订的群体疼痛的痛苦较小。在术后不稳定性的9个肩部中，7术后7次损害了软组织。结论：HHR后修订TSA导致疼痛减少和议案增加。然而，结果评级是相当变化的，并且在许多情况下，不满意。根据复杂性的程序分层没有表现出运动，满意度或生存的差异。然而，干扰导致疼痛评分改善降低。与亚肩胛下和前肩囊损伤相关的共存不稳定性可能无法使用不受约束的肩部表成形塑料成形术。

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