Do Constrained Liners (in a 145° onlay implant) Provide Any Benefit? A Matched Retrospective Study.

IF 2.9 2区医学 Q1 ORTHOPEDICS

Journal of Shoulder and Elbow Surgery Pub Date : 2024-10-18 DOI:10.1016/j.jse.2024.08.042

Samuel Lorentz, Caroline N Park, Christopher P Roche, Christopher S Klifto, Oke A Anakwenze

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引用次数: 0

Abstract

Background: The purpose of this study was to compare the outcomes of primary reverse total shoulder arthroplasty (rTSA) using constrained liners (in a 145° onlay implant, Exactech, Equinoxe) with primary rTSA using standard liners with a minimum 1-year follow-up.

Methods: A total of 836 primary rTSA patients were analyzed in this study. Patients treated with constrained liners (n=209) were cross-matched 1:3 for age, gender, glenosphere diameter, and follow-up duration, and compared with 627 patients who underwent primary rTSA with standard liners. Study endpoint was at one year. Outcomes were analyzed preoperatively and at the latest follow-up. Patient characteristics, postoperative range of motion (ROM), patient reported outcomes (PROs), complications and revisions were recorded.

Results: There was no statistically significant changes in improvement in pain (-4.9 vs -5.1; p=0.356), ROM (abduction, 45.7° vs 47.9°; p=0.522) (forward elevation, 44.0 vs 50.8°; p=0.057) (internal rotation score 1.0 vs 1.1; p=0.709) (external rotation, 17.9° vs 16.7°; p=0.543), or PROs (American Shoulder and Elbow Surgeons Score, 44.5 vs 43.7; p=0.107) (Shoulder Arthroplasty Smart score, 27.5 vs 30.0; p=0.052) between the constrained and standard liner cohorts at minimum 1 year follow-up. However, the constrained liner rTSA cohort had a significantly higher rate of adverse events (6.2% vs. 2.7%; p=0.012), including a higher rate of scapular notching (15.6% vs. 8.8%; p=0.015).

Conclusion: The utilization of constrained liners in primary rTSA demonstrated no significant difference in the change in pain, abduction, forward elevation, ER and IR scores, ASES scores, and SAS scores at minimum 1-year follow-up. There was no significant difference in forward elevation or abduction compared to standard liners. However, we observed that the overall rate of adverse events, including scapular notching were significantly higher in the constrained liner cohort. Long-term clinical and radiographic follow-up is necessary to fully elucidate the durability of these results. At this time, it is unclear if constrained liners have any benefit in rTSA.

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145°嵌体中的约束衬垫是否有益？一项匹配的回顾性研究。

背景：本研究的目的是比较使用限制性衬垫（145°onlay植入物，Exactech，Equinoxe）的初级反向全肩关节置换术（rTSA）与使用标准衬垫的初级rTSA的疗效，并进行至少1年的随访：本研究共分析了 836 例原发性 rTSA 患者。使用约束衬垫治疗的患者（209 人）与使用标准衬垫进行初级 rTSA 治疗的 627 名患者在年龄、性别、肾盂直径和随访时间上进行了 1:3 的交叉配对，并进行了比较。研究终点为一年后。对术前和最近一次随访的结果进行了分析。研究记录了患者特征、术后活动范围（ROM）、患者报告结果（PROs）、并发症和翻修情况：结果：疼痛（-4.9 vs -5.1；P=0.356）、ROM（外展，45.7° vs 47.9°；P=0.522）（前抬，44.0 vs 50.8°；P=0.057）（内旋评分 1.0 vs 1.1；P=0.709）（外旋，17.9° vs 16.7°；P=0.057）的改善无统计学意义。在至少 1 年的随访中，约束衬垫组和标准衬垫组之间的PROs（美国肩肘外科医生评分，44.5 vs 43.7；p=0.107）（肩关节成形术智能评分，27.5 vs 30.0；p=0.052）或PROs（美国肩肘外科医生评分，44.5 vs 43.7；p=0.107）无明显差异。然而，约束衬垫rTSA队列的不良事件发生率明显更高（6.2% vs. 2.7%; p=0.012），包括肩胛骨切迹发生率更高（15.6% vs. 8.8%; p=0.015）：结论：在原发性RTSA中使用约束衬垫，在至少1年的随访中，疼痛、外展、前伸、ER和IR评分、ASES评分和SAS评分的变化无显著差异。与标准衬垫相比，前伸或外展没有明显差异。不过，我们观察到，在约束衬垫组中，包括肩胛骨切迹在内的不良事件发生率明显更高。有必要进行长期临床和放射学随访，以充分了解这些结果的持久性。目前，尚不清楚约束衬垫是否对 rTSA 有任何益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Shoulder and Elbow Surgery 医学-外科

CiteScore

6.50

自引率

23.30%

发文量

604

审稿时长

11.2 weeks

期刊介绍： The official publication for eight leading specialty organizations, this authoritative journal is the only publication to focus exclusively on medical, surgical, and physical techniques for treating injury/disease of the upper extremity, including the shoulder girdle, arm, and elbow. Clinically oriented and peer-reviewed, the Journal provides an international forum for the exchange of information on new techniques, instruments, and materials. Journal of Shoulder and Elbow Surgery features vivid photos, professional illustrations, and explicit diagrams that demonstrate surgical approaches and depict implant devices. Topics covered include fractures, dislocations, diseases and injuries of the rotator cuff, imaging techniques, arthritis, arthroscopy, arthroplasty, and rehabilitation.