人工肩关节假体修复肩关节损伤

背景：肩关节置换成功的关键是尽可能重建肱骨近端的解剖结构,目前人工肩关节假体种类繁多,疗效差异较大。目的：总结人工肩关节假体在肩关节损伤修复中的应用进展。方法：由第一作者用计算机检索万方数据库、中国期刊全文数据库（CNKI）和PubMed数据库,检索时间为1999/2012,检索词分别为＂肩关节,人工假体＂和＂should erjoint,Artificial falsebody＂。从人工肩关节假体的类型,设计,应用及并发症方面进行总结,全面介绍人工肩关节假体在肩关节损伤修复中的应用进展。共检索到86篇文章,按纳入和排除标准对文献进行筛选,共纳入25篇文章。结果与结论：目前常用的人工肩关节假体中,UNIVERS3-D和Aequalis骨折型肩关节假体临床效果较好,置换后并发症及翻修率低,生物相容性较好。DeltaⅢ逆置式肩关节假体植入后因肩胛盂下凹槽形成及脱位等并发症,而致翻修率较高,生物相容性较差。因此,正确选择病例、熟悉肩关节的解剖学机制和肩关节特殊的重建技术,并在此基础上制定周密的置换方案可以降低人工肩关节假体置换并发症的发生,从而提高假体和宿主的生物相容性。

Artificial shoulder prosthesis for repair of shoulder joint injury

BACKGROUND：Shoulder joint replacement is dependent on the reconstruction of the proximal humerus anatomical structure,at present,there are a wide variety of artificial shoulder prosthesis,which greatly vary in the efficacy.OBJECTIVE：To summarize the application progress of artificial shoulder prosthesis in the repair of shoulder joint injury.METHODS：A computer-based online retrieval was performed by the first author among Wanfang database,China National Knowledge Infrastructure（CNKI） database and PubMed database between 1999 and 2012,using the of ＂shoulder joint,prosthesis＂ in Chinese and ＂shoulder joint,artificial false body＂ in English.Articles addressing the type,design,application and complication of shoulder joint prosthesis were included,as well as those regarding the role of shoulder joint prosthesis in the repair of shoulder joint injury were selected.A total of 86 articles were screened out according to inclusion and exclusion criteria,and 25 articles of them were involved in the analysis.RESULTS AND CONCLUSION：UNIVERS3-D and Aequalis fracture shoulder prosthesis are the commonly used,because of good clinical efficacy,little complications and low revision rate after the replacement,and good biocompatibility.Delta reverse replacement of shoulder joint prosthesis shows a high revision rate and poor biocompatibility as a result of scapular notching and dislocation.Therefore,proper selection of cases,understanding of the anatomy of shoulder joint and the special reconstruction technology of shoulder joint,as well as a careful replacement scheme can reduce the replacement complications of artificial shoulder prosthesis,thereby improving the biocompatibility between the prosthesis and the host.