Publication: Evolución de la prótesis invertida de hombro. Indicaciones, complicaciones y técnica. Mi experiencia personal
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2023-11-10
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Universidad Complutense de Madrid
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Abstract
La prótesis total invertida de hombro (PTIH) se diseñó inicialmente para el tratamiento de la artropatía del manguito rotador y debido al éxito obtenido, se ha extendido su indicación a múltiples procesos degenerativos y traumáticos del hombro. El trabajo que presentamos agrupa cuatro artículos publicados sobre diversos aspectos que giran en torno a la evolución en el uso de la PTIH. Los tres primeros estudios son trabajos retrospectivos que analizan diferentes indicaciones actuales de las prótesis invertidas de hombro: artrosis de hombro con defecto óseo glenoideo, rescate de osteosíntesis fallidas tras fractura proximal de húmero y fracturas desplazadas de la extremidad proximal del húmero. El primer estudio analiza las complicaciones, la tasa de consolidación y los resultados funcionales del uso de injerto óseo glenoideo (aloinjerto y autoinjerto)para la reconstrucción glenoidea en cirugía primaria o de revisión de PTIH. Se identificaron 20 pacientes intervenidos entre 2011 y 2014. La puntuación media de la escala de Constant mejoró de 30.7 ± 9,4 puntos a 51.3 ± 13.4 puntos. La tomografía axial computerizada (TAC) confirmó la consolidación del injerto en la glena en el 95% de los casos. No se encontraron diferencias estadísticamente significativas en el análisis de los resultados clínicos y radiográficos relacionados con la fuente del injerto. Hubo una tasa de complicaciones postoperatorias del 20%...
The reverse total shoulder arthroplasty (RTSA) was initially designed for the treatment of rotator cuff arthropathy and due to its success, its indication has been extended to multiple degenerative and traumatic processes of the shoulder The work that we present brings together four articles published on various aspects concerning the evolution of the use of the RTSA. The first three studies are retrospective works that analyze different current indications for RTSA: shoulder osteoarthritis with glenoid bone defect, salvage of failed osteosynthesis after proximal humerus fracture, and displaced fractures of the proximal humerus. The first study analyzes the complications, rate of healing, and functional results of the use of glenoid bone grafting (allograft and autograft) for glenoid reconstructionin primary or revision surgery of RTSA. Twenty patients who underwent surgery between 2011 and 2014 were identified. The mean Constant scale score improved from 30.7 ± 9.4 points to 51.3 ± 13.4 points. Computerized axial tomography confirmed graft consolidation in the glenoid in 95% of the cases. No statistically significant differences were found in the analysis of clinical and radiographic results related to the graft used. There was a 20% of postoperative complication rate...
The reverse total shoulder arthroplasty (RTSA) was initially designed for the treatment of rotator cuff arthropathy and due to its success, its indication has been extended to multiple degenerative and traumatic processes of the shoulder The work that we present brings together four articles published on various aspects concerning the evolution of the use of the RTSA. The first three studies are retrospective works that analyze different current indications for RTSA: shoulder osteoarthritis with glenoid bone defect, salvage of failed osteosynthesis after proximal humerus fracture, and displaced fractures of the proximal humerus. The first study analyzes the complications, rate of healing, and functional results of the use of glenoid bone grafting (allograft and autograft) for glenoid reconstructionin primary or revision surgery of RTSA. Twenty patients who underwent surgery between 2011 and 2014 were identified. The mean Constant scale score improved from 30.7 ± 9.4 points to 51.3 ± 13.4 points. Computerized axial tomography confirmed graft consolidation in the glenoid in 95% of the cases. No statistically significant differences were found in the analysis of clinical and radiographic results related to the graft used. There was a 20% of postoperative complication rate...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 20-02-2023. Tesis formato europeo (compendio de artículos)