Geometrical analysis of Copeland surface replacement shoulder arthroplasty in relation to normal anatomy

被引:61
|
作者
Thomas, SR [1 ]
Sforza, G [1 ]
Levy, O [1 ]
Copeland, SA [1 ]
机构
[1] Royal Berkshire Hosp, Reading Shoulder Surg Unit, Reading RG1 5AN, Berks, England
关键词
D O I
10.1016/j.jse.2004.06.013
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
This study examines the effect of humeral head surface replacement on the geometry of the arthritic glenohumeral joint and correlates changes to clinical outcome. Thirty-nine patients undergoing resurfacing orthroplosty were prospectively followed up clinically and radiologically for a mean of 38 months (range, 24 to 72 months). Measurements were taken from coronal radiographs by use of a validated technique. There was an estimated mean 6 mm erosion of preoperative lateral offset (coracoid base to greater tuberosity). The prosthesis reduced the humeral head radius by a mean of 3.5%. Humeral offset (greater tuberosity to center of instant rotation) increased by a mean of 5 mm (95% Cl, 3.8 to 6.4; P < .0 1). Mean age-/sex-adjusted Constant scores improved from 26 to 83 points (P < .0 1). The improved postoperative motion showed a nonlinear relationship with humeral offset. We conclude that surface replacement restores humerol offset and the lever arm of the deltoid and suprospinatus while otherwise mimicking individual anatomy. Function depends on adequate restoration of this lever arm without overstuffing the joint.
引用
收藏
页码:186 / 192
页数:7
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