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为什么今天初级解剖学全肩关节置换术会失败? 一个系统的审查和元分析
Bradley J Lauck1, Jackson M Cathey2, Nathan C Adams1
1The University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Journal of shoulder and elbow surgery
|April 16, 2025
概括
植入物松动是解剖学全肩关节整形术失败的主要原因,特别是状腺松动. 旋转手套问题,感染和不稳定性也是导致aTSA失败的重要因素.
科学领域:
- 整形外科手术 整形外科手术
- 生物医学工程 生物医学工程
- 关节塑造研究 关节塑造研究
背景情况:
- 解剖学全肩关节整形术 (aTSAs) 越来越多地用于关节骨关节炎.
- 尽管结果有利,但显著的失败率需要对aTSA失败的主要原因进行分析.
研究的目的:
- 进行对原发性解剖学性全肩关节整形术失败原因的系统审查和元分析.
- 确定常见的失败模式,并为患者选择,手术技术和植入物设计的改进提供信息.
主要方法:
- 按照PRISMA指南进行系统审查和元分析.
- 在主要数据库 (PubMed,CINAHL,Embase,SPORTDiscus) 进行文献搜索,从2014年到2024年.
- 使用随机效应模型来确定失败率和置信区间的比例元分析.
主要成果:
- 对包括35,168个aTSA在内的44项研究的分析显示,植入物松动 (26.1%) 是主要的失效模式,特别是状腺松动 (21.7%).
- 旋转手套缺陷 (17.3%),不稳定 (10.4%) 和感染 (10.2%) 是其他主要原因.
- 早期失败 (<5年) 与松,旋转手套问题和感染有关;晚期失败 (>5年) 主要是由于状腺松.
结论:
- 植入物松,特别是状元件,是当代aTSA失效的最常见原因.
- 旋转手套缺陷,不稳定性和感染也是aTSA失败的关键因素.
- 研究结果强调了aTSA失败的多因素性质,以及改善植入物存活率的领域.
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