Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
권호 표지
DOI QR코드

DOI QR Code

The Current State of Total Shoulder Arthroplasty

견관절 전치환술의 현재

  • Oh, Joo-Han (Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Song, Byung-Wook (Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital)
  • 오주한 (서울대학교 의과대학 정형외과학교실, 분당서울대학교병원 관절센터) ;
  • 송병욱 (서울대학교 의과대학 정형외과학교실, 분당서울대학교병원 관절센터)
  • Received : 2011.09.17
  • Accepted : 2011.11.25
  • Published : 2011.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of the present article is to help orthopedic surgeons better understand the basic principles of unconstrained total shoulder arthroplasty, and to help them perform the best surgical technique for reconstruction. Materials and Methods: In this article, we reviewed in depth current biomechanics, indications & contraindications, surgical techniques, complications and outcomes of unconstrained total shoulder arthroplasty. Additionally, we discussed current issues relevant to total shoulder arthroplasty such as whether a keeled or a pegged glenoid should be used. Results and Conclusion: A thorough understanding of the biomechanics of total shoulder arthroplasty, and the technical details and problems in implantation, are critical to provide the best functional outcome and to avoid the risk of complications.

목적: 정형외과 의사로 하여금 비구속형 견관절 전치환술의 기본적인 원칙들을 더 잘 이해할 수 있게 함과 동시에, 적절한 수술적 치료를 시행하는데 도움을 주고자 한다. 대상 및 방법: 비구속형 견관절 전치환술의 생역학, 적응증 및 금기, 수술 기법, 합병증 및 결과에 관한 최근 추세를 심도 있게 다루고자 하였으며, keel 형태 또는 peg 형태의 관절와 삽입물중 어느 것을 사용하는 것이 적합한 지에 관한 논란 등 견관절 전치환술과 관련된 최근의 주된 관심사에 대해서도 살펴보고자 하였다. 결과 및 결론: 수술 후 합병증을 피하며 최선의 기능적 결과를 얻기 위해서는 견관절 전치환술의 생역학, 그리고 그 수술 기법과 주의점에 대한 철저한 이해가 필수적이다.

Keywords

References

  1. Krueger FJ. A vitallium replica arthroplasty on the shoulder; a case report of aseptic necrosis of the proximal end of the humerus. Surgery. 1951;30:1005-11.
  2. Neer CS, 2nd. Articular replacement for the humeral head. J Bone Joint Surg Am. 1955;37:215-28. https://doi.org/10.2106/00004623-195537020-00001
  3. Boileau P, Walch G. The three-dimensional geometry of the proximal humerus. Implications for surgical technique and prosthetic design. J Bone Joint Surg Br. 1997;79:857-65. https://doi.org/10.1302/0301-620X.79B5.7579
  4. Pearl ML, Volk AG. Coronal plane geometry of the proximal humerus relevant to prosthetic arthroplasty. J Shoulder Elbow Surg. 1996;5:320-6. https://doi.org/10.1016/S1058-2746(96)80060-7
  5. Pearl ML, Volk AG. Retroversion of the proximal humerus in relationship to prosthetic replacement arthroplasty. J Shoulder Elbow Surg. 1995;4:286-9. https://doi.org/10.1016/S1058-2746(05)80022-9
  6. Roberts SN, Foley AP, Swallow HM, Wallace WA, Coughlan DP. The geometry of the humeral head and the design of prostheses. J Bone Joint Surg Br. 1991;73:647-50. https://doi.org/10.2106/00004623-199173050-00002
  7. Neer CS, 2nd. Replacement arthroplasty for glenohumeral osteoarthritis. J Bone Joint Surg Am. 1974; 56:1-13. https://doi.org/10.2106/00004623-197456010-00001
  8. Anglin C, Wyss UP, Pichora DR. Mechanical testing of shoulder prostheses and recommendations for glenoid design. J Shoulder Elbow Surg. 2000;9:323-31. https://doi.org/10.1067/mse.2000.105451
  9. Anglin C, Wyss UP, Nyffeler RW, Gerber C. Loosening performance of cemented glenoid prosthesis design pairs. Clin Biomech (Bristol, Avon). 2001;16: 144-50. https://doi.org/10.1016/S0268-0033(00)00078-4
  10. Edwards TB, Labriola JE, Stanley RJ, O'Connor DP, Elkousy HA, Gartsman GM. Radiographic comparison of pegged and keeled glenoid components using modern cementing techniques: a prospective randomized study. J Shoulder Elbow Surg. 2010;19:251-7. https://doi.org/10.1016/j.jse.2009.10.013
  11. Gartsman GM, Elkousy HA, Warnock KM, Edwards TB, O'Connor DP. Radiographic comparison of pegged and keeled glenoid components. J Shoulder Elbow Surg. 2005;14:252-7. https://doi.org/10.1016/j.jse.2004.09.006
  12. Throckmorton TW, Zarkadas PC, Sperling JW, Cofield RH. Pegged versus keeled glenoid components in total shoulder arthroplasty. J Shoulder Elbow Surg. 2010;19:726-33. https://doi.org/10.1016/j.jse.2009.10.018
  13. Boileau P, Avidor C, Krishnan SG, Walch G, Kempf JF, Mole D. Cemented polyethylene versus uncemented metal-backed glenoid components in total shoulder arthroplasty: a prospective, double-blind, randomized study. J Shoulder Elbow Surg. 2002;11: 351-9. https://doi.org/10.1067/mse.2002.125807
  14. Castagna A, Randelli M, Garofalo R, Maradei L, Giardella A, Borroni M. Mid-term results of a metalbacked glenoid component in total shoulder replacement. J Bone Joint Surg Br. 2010;92:1410-5. https://doi.org/10.1302/0301-620X.92B10.23578
  15. Fucentese SF, Costouros JG, Kuhnel SP, Gerber C. Total shoulder arthroplasty with an uncemented softmetal- backed glenoid component. J Shoulder Elbow Surg. 2010;19:624-31. https://doi.org/10.1016/j.jse.2009.12.021
  16. Karduna AR, Williams GR, Williams JL, Iannotti JP. Joint stability after total shoulder arthroplasty in a cadaver model. J Shoulder Elbow Surg. 1997;6:506-11. https://doi.org/10.1016/S1058-2746(97)90082-3
  17. Walch G, Edwards TB, Boulahia A, Boileau P, Mole D, Adeleine P. The influence of glenohumeral prosthetic mismatch on glenoid radiolucent lines: results of a multicenter study. J Bone Joint Surg Am. 2002;84: 2186-91. https://doi.org/10.2106/00004623-200212000-00010
  18. Wang VM, Krishnan R, Ugwonali OF, Flatow EL, Bigliani LU, Ateshian GA. Biomechanical evaluation of a novel glenoid design in total shoulder arthroplasty. J Shoulder Elbow Surg. 2005;14:129S-40S. https://doi.org/10.1016/j.jse.2004.09.029
  19. Nuttall D, Haines JF, Trail IA. The effect of the offset humeral head on the micromovement of pegged glenoid components: a comparative study using radiostereometric analysis. J Bone Joint Surg Br. 2009;91:757-61. https://doi.org/10.1302/0301-620X.91B6.22060
  20. Walch G, Badet R, Boulahia A, Khoury A. Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplasty. 1999;14:756-60. https://doi.org/10.1016/S0883-5403(99)90232-2
  21. Gerber C, Yian EH, Pfirrmann CA, Zumstein MA, Werner CM. Subscapularis muscle function and structure after total shoulder replacement with lesser tuberosity osteotomy and repair. J Bone Joint Surg Am. 2005;87:1739-45. https://doi.org/10.2106/JBJS.D.02788
  22. Qureshi S, Hsiao A, Klug RA, Lee E, Braman J, Flatow EL. Subscapularis function after total shoulder replacement: results with lesser tuberosity osteotomy. J Shoulder Elbow Surg. 2008;17:68-72. https://doi.org/10.1016/j.jse.2007.04.018
  23. Campbell JT, Moore RS, Iannotti JP, Norris TR, Williams GR. Periprosthetic humeral fractures: mechanisms of fracture and treatment options. J Shoulder Elbow Surg. 1998;7:406-13. https://doi.org/10.1016/S1058-2746(98)90033-7
  24. Ricchetti ET, Williams Jr GR. Total Shoulder Arthroplasty? Indications, Technique, and Results. Oper Tech in Orthop. 2011;21:28-38. https://doi.org/10.1053/j.oto.2010.11.001
  25. Nyffeler RW, Meyer D, Sheikh R, Koller BJ, Gerber C. The effect of cementing technique on structural fixation of pegged glenoid components in total shoulder arthroplasty. J Shoulder Elbow Surg. 2006;15:106-11. https://doi.org/10.1016/j.jse.2005.05.002
  26. Brems J. Rehabilitation After Total Shoulder Arthroplasty: Current Concepts. Seminars in Arthroplasty. 2007;18:55-65. https://doi.org/10.1053/j.sart.2006.11.001
  27. Bohsali KI, Wirth MA, Rockwood CA. Current Concepts Review: Complications of Total Shoulder Arthroplasty. J Bone Joint Surg Am. 2006;88:2279-92. https://doi.org/10.2106/JBJS.F.00125
  28. Edwards TB, Kadakia NR, Boulahia A, et al. A comparison of hemiarthroplasty and total shoulder arthroplasty in the treatment of primary glenohumeral osteoarthritis: results of a multicenter study. J Shoulder Elbow Surg. 2003;12:207-13. https://doi.org/10.1016/S1058-2746(02)86804-5
  29. Cil A, Veillette CJ, Sanchez-Sotelo J, Sperling JW, Schleck CD, Cofield RH. Survivorship of the humeral component in shoulder arthroplasty. J Shoulder Elbow Surg. 2010;19:143-50. https://doi.org/10.1016/j.jse.2009.04.011
  30. Martin SD, Zurakowski D, Thornhill TS. Uncemented glenoid component in total shoulder arthroplasty. Survivorship and outcomes. J Bone Joint Surg Am. 2005;87:1284-92. https://doi.org/10.2106/JBJS.C.00947
  31. Sperling JW, Cofield RH, Rowland CM. Minimum fifteen-year follow-up of Neer hemiarthroplasty and total shoulder arthroplasty in patients aged fifty years or younger. J Shoulder Elbow Surg. 2004;13:604-13. https://doi.org/10.1016/j.jse.2004.03.013
  32. Fox TJ, Cil A, Sperling JW, Sanchez-Sotelo J, Schleck CD, Cofield RH. Survival of the glenoid component in shoulder arthroplasty. J Shoulder Elbow Surg. 2009; 18:859-63. https://doi.org/10.1016/j.jse.2008.11.020

Cited by

  1. Structural Analysis of Proximal Humerus in Korean vol.48, pp.5, 2013, https://doi.org/10.4055/jkoa.2013.48.5.359
  2. Clinical Application of Three-Dimensional Reconstruction in Shoulder Surgeries vol.1, pp.2, 2014, https://doi.org/10.18204/JISSiS.2014.1.2.067