中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (22): 4066-4069.doi: 10.3969/j.issn.1673-8225.2010.22.019

• 骨与关节综述 bone and joint review • 上一篇    下一篇

Delta Ⅲ 逆置式肩关节假体置换的相关问题

魏余贤，黄  伟   

  1. 重庆医科大学附属第一医院骨科，重庆市  400016
  • 出版日期:2010-05-28 发布日期:2010-05-28
  • 通讯作者: 黄 伟，硕士生导师，教授，重庆医科大学附属第一医院骨科，重庆市 400016
  • 作者简介:魏余贤★，男，1984年生，湖北省十堰市人，汉族，重庆医科大学在读硕士，主要从事肩关节假体的相关研究。 saltish0301@163.com

Issues regarding Delta III reverse shoulder arthroplasty

Wei Yu-xian, Huang Wei    

  1. Department of Orthopedics, First Affiliated Hospital of Chongqing Medical University, Chongqing  400016, China
  • Online:2010-05-28 Published:2010-05-28
  • Contact: Huang Wei, Professor, Master’s supervisor, Department of Orthopedics, First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
  • About author:Wei Yu-xian★, Studying for master’s degree, Department of Orthopedics, First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China saltish0301@163.com

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501

被引次数

2

摘要：

背景：Delta Ⅲ逆置式肩关节假体是极富创新性的假体，不仅颠覆了标准肩袖修复方法和肩关节假体置换的技术思路，也补充了对于难以修复的肩袖撕裂和传统的肩关节假体置换失败后再行翻修的空白。
目的：介绍Delta Ⅲ逆置式肩关节假体的生物力学特点、假体组成、手术技巧及常见并发症，为中国的临床使用提供参考。
方法：由第一作者检索1991/2010 PubMed数据库(http://www.ncbi.nlm.nih.gov/PubMed)及法国权威骨科网(http：//www.maitrise-orthopedie.fr)有关逆置式肩关节假体置换的相关文献。英文检索词为“reverse shoulder arthroplasty，Grammont shoulder，Delta shoulder”，中文文献未见确切报道，未参考。排除重复文献。计算机初检得到177篇文献，根据纳入标准保留31篇进一步归纳总结。
结果与结论：Delta Ⅲ逆置式肩关节假体根据假体组分所在部位可分为肱骨端和关节盂端两部分。Delta Ⅲ逆置式肩关节假体植入后对疼痛缓解明显，外展动作角度明显增大，但外旋、内旋动作无明显提高。患者满意度较高，但因肩胛盂下凹槽形成、脱位等并发症，而致翻修率较高。在国内的临床使用中仍待综合分析其收益并进一步全面评估其应用价值。

关键词: 肩关节, 逆置式全肩关节假体, Delta III, 人工假体, 医学植入物

Abstract:

BACKGROUND: Delta Ⅲ is a novel reversed prosthesis for the shoulder. It inverts standard techniques for cuff tears, and supplements the concept used for revision surgery after previous failure of hemi- or total arthroplasty for shoulder joints.
OBJECTIVE: To introduce the new concept of mechanism, components, operative techniques and common complications of Delta III prosthesis in clinical settings, to provide a reference for clinical practice.
METHODS: A computer-based online search of Pubmed (http://www.ncbi.nlm.nih.gov/PubMed) and matrise orthopedie (http://www.maitrise-orthopedie.fr) was performed for articles published between 1991 and 2010 with key words “reverse shoulder arthroplasty, Grammont shoulder, Delta shoulder”. Chinese articles were not included. Repetitive articles were excluded. A total of 177 articles were collected and 31 were analyzed.
RESULTS AND CONCLUSION: Delta Ⅲ prosthesis included humerus and glenoid cavity ends. Delta Ⅲ reverse shoulder arthroplasty could obviously relieve pain and improve range of motion, particularly on abduction, but it seems to have no further effect on rotations. Satisfaction is quite good, but the trouble exists at a high rate of scapular notching and dislocation, which results in revision. The value and its benefits are required to be evaluated in domestic clinical practice.

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