Geoffrey W Schemitsch, Patrick Carroll, Patrick Henry, Diane Nam, Ujash Sheth
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引用次数: 0
Abstract
Background: Pyrocarbon has been trialed as an alternative bearing surface to metal for young active patients with glenohumeral joint arthritis. The aim of this study was to systematically review and summarize the available evidence on reported outcomes of pyrocarbon implants in shoulder arthroplasty.
Methods: A systematic review was conducted according and reported according to standardized guidelines. Patient demographics, complications, implant survivorship and patient-reported outcome measures were extracted and included in the quantitative analysis. Outcome data was summarized with weighted mean differences and proportions.
Results: Fifteen studies were included with 904 patients and a median follow-up of 38 months. The pooled mean range of motion improvement was 43.9 degrees (95% confidence interval [95% CI] 36.7-51.2) in forward elevation and 24.1 degrees (95% CI 18.4-29.9) in external rotation. Pooled mean Constant Score improvement was 34.7 (95% CI 29.4-40.1) and Subjective Shoulder Value improvement was 40.6 (95% CI 33.4-47.8). The overall pooled re-operation rate was 8.03% (95% CI 5%-12.7%).
Discussion: Pyrocarbon shoulder implants demonstrated improvements in functional outcomes with low revision rates at early- to mid-term follow-up. Further well-designed prospective studies with long-term follow-up are required to verify the safety and efficacy of pyrocarbon implants in shoulder arthroplasty.
背景:焦碳已被试验作为金属的替代承载表面用于年轻活动期肩关节关节炎患者。本研究的目的是系统地回顾和总结关于肩关节置换术中热炭植入物的报道结果的现有证据。方法:根据标准化指南进行系统评价和报告。提取患者人口统计数据、并发症、种植体存活和患者报告的结果测量,并将其纳入定量分析。结果数据以加权平均差异和比例进行汇总。结果:纳入15项研究,904例患者,中位随访38个月。前仰的平均运动范围改善为43.9度(95%可信区间[95% CI] 36.7-51.2),外旋的平均运动范围改善为24.1度(95% CI 18.4-29.9)。合并平均恒评分改善为34.7 (95% CI 29.4-40.1),主观肩值改善为40.6 (95% CI 33.4-47.8)。总再手术率为8.03% (95% CI 5% ~ 12.7%)。讨论:在早期到中期随访中,炭肩植入物显示出功能结果的改善,翻修率低。需要进一步精心设计的长期随访前瞻性研究来验证热炭假体在肩关节置换术中的安全性和有效性。