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Surface Replacement Arthroplasty of the Humeral Head in Young, Active Patients

机译:年轻活跃患者的肱骨头表面置换关节置换术

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Background: The treatment of glenohumeral arthritis in young, active patients remains controversial. Standard total shoulder arthroplasty in this patient group has not obtained the same satisfaction rate as in older patients. One surgical option that has emerged is humeral resurfacing. Hypothesis: Humeral head surface replacement arthroplasty (SRA) would provide satisfactory clinical outcomes in active patients, allowing them to maintain their normal lifestyle without activity restrictions. Study Design: Case series; Level of evidence, 4. Methods: From 2004 to 2007, all consecutive surface replacement arthroplasties of the humerus performed at the authors’ institution were identified and retrospectively reviewed, and 118 patients who underwent SRA during this time were identified. This study included patients younger than 60 years who wished to maintain an active lifestyle; 52 of the 118 patients met the inclusion criteria. University of California at Los Angeles (UCLA) shoulder scores and subjective shoulder value (SSV) scores were used to measure clinical outcomes at an average follow-up of 6 years (range, 4-8 years). Of the 52 patients meeting the inclusion criteria, 48 were contacted and examined for the study, with 4 patients lost to follow-up. Results: The mean postoperative UCLA score was 28.03, with 1 patient requiring revision because of pain and glenoid wear. The mean SSV was 92% (range, 0%-100%), with 3 patients restricting their activity because of the shoulder. Forty-seven of the 48 contacted patients stated that, given the option, they would have the same surgery again. One patient required revision surgery because of pain. Conclusion: Surface replacement arthroplasty provided reasonable results in patients younger than 60 years with high activity demands with a low rate of revision at midterm follow-up.
机译:背景:年轻,活跃患者的盂肱关节炎的治疗仍存在争议。该患者组的标准全肩关节置换术没有获得与老年患者相同的满意率。出现的一种外科手术选择是肱骨表面重修。假设:肱骨头置换术(SRA)将为活跃的患者提供令人满意的临床效果,使他们能够保持正常的生活方式而没有活动限制。研究设计:案例系列;证据等级:4。方法:从2004年至2007年,对作者所在机构进行的所有连续的肱骨表面置换置换术进行了鉴定并进行了回顾性检查,确定了118例在此期间接受SRA的患者。这项研究纳入了60岁以下希望保持积极生活方式的患者。 118名患者中有52名符合纳入标准。加州大学洛杉矶分校(UCLA)的肩膀评分和主观的肩膀价值(SSV)评分用于衡量平均6年(4-8年)的临床结局。在符合纳入标准的52位患者中,有48位与之联系并进行了研究检查,其中4位患者失访。结果:术后平均UCLA评分为28.03,其中1例患者因疼痛和关节盂磨损而需要翻修。平均SSV为92%(范围为0%-100%),其中3例患者由于肩部活动受限。在48位接触的患者中,有47位表示,如果有选择,他们将再次进行相同的手术。一名患者因疼痛而需要翻修手术。结论:表面置换关节置换术在60岁以下,活动需求高,中期随访时翻修率低的患者中提供了合理的结果。

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