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Humeral bone resorption after reverse shoulder arthroplasty using uncemented stem

机译:逆转肩部关节置换术后肱骨骨吸收使用未照相茎

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Background:Humeral stem loosening has gained attention as it has been identified as a cause of revision surgery in reverse shoulder arthroplasty (RSA). In RSA, humeral stem revision is very difficult if there is humeral bone loss because of stress shielding. Some studies of humeral bone resorption after anatomic shoulder arthroplasty have been published, but there are few detailed reports of humeral bone resorption after RSA. This study aimed to investigate the prevalence of humeral bone resorption after RSA procedures and to evaluate the risk factors for bone resorption.Methods:This study included 48 shoulders that underwent RSA with an uncemented humeral stem from July 2014 to May 2017 and were followed up for more than 1 year. The prevalence of humeral bone resorption and risk factors were investigated. Logistic, multiple logistic, and multivariate logistic regression analyses were performed to evaluate the data.Results:Grade 0 bone resorption, the most advanced grade, occurred in 8 shoulders (16.7%); grade 1, in 0 (0%); grade 2, in 17 (35.4%); grade 3, in 14 (29.2%); and grade 4, in 9 (18.8%). A high occurrence of bone absorption was observed in zones 1, 2, and 7. Grade 4 bone resorption did not occur in zones 3, 5, and 6. Female sex and an onlay-type stem were significant independent risk factors for grade 4 bone resorption.Conclusions:Bone resorption was frequently observed in the greater tuberosity, lateral diaphysis, and calcar region. Significant risk factors included female sex and an onlay-type stem.? 2019 The Author(s).
机译:背景技术:肱骨杆松动的关注,因为它被识别为反向肩部关节置换术(RSA)的修复手术原因。在RSA中,如果由于压力屏蔽而存在肱骨骨质损失,肱骨干燥性是非常困难的。在解剖肩部关节成形术后肱骨骨吸收的一些研究已发表,但RSA后肱骨骨吸收的详细报道少。本研究旨在调查RSA程序后肱骨骨吸收的患病率,并评估骨吸收的危险因素。方法:这项研究包括48名肩膀,从2014年7月到2017年5月,未发行的肱骨杆接受了RSA,并进行了跟进超过1年。研究了肱骨骨吸收和危险因素的患病率。进行逻辑,多种逻辑和多变量逻辑回归分析来评估数据。结果:0级骨吸收,最先进的等级,发生在8个肩部(16.7%); 1级,0(0%); 2年级,17级(35.4%); 3级,14级(29.2%);和4级,9(18.8%)。在区域1,2和7中观察到高发生的骨吸收。4级骨吸收不会发生在4,5和6.雌性性和镶嵌型茎中的4级骨骼的显着独立危险因素吸收。结论:在较大的结节,横向骨干和轮廓区域中经常观察到骨吸收。显着的风险因素包括女性和镶嵌型茎。 2019年作者。

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