Publication: Estudio anatómico y fotoelástico de las prótesis invertidas de hombro
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2020-01-13
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Universidad Complutense de Madrid
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Abstract
La artroplastia invertida de hombro ha presentado un aumento global de su uso debido a sus buenos resultados clínicos. No solo se aprecia la mejoría en el postoperatorio inmediato, sino que se mantiene a medio y largo plazo. Sin embargo, éstas no están exentas de complicaciones. La tasa de alteraciones neurológicas, encontradas mediante estudios neurofisiológicos, es mayor que la encontrada en las prótesis anatómicas de hombro. Una de las justificaciones que se podrían dar a este hecho es el alargamiento del brazo que se produce al implantar una prótesis invertida, ya que la base biomecánica de estas consiste en descender y medializar el centro de rotación del hombro para ofrecer mayor brazo de palanca al deltoides y así poder restablecer el balance articular. Este descenso del centro de rotación de la articulación produce un alargamiento del brazo, que podría llevar asociado un alargamiento de las estructuras neurológicas del mismo, predisponiendo a su lesión...
The utilization of the reverse shoulder arthroplasty (RSA) has increased due to its good clinical outcomes. These good results have not only been documented in the early postoperative period, but also in mid and long term in clinical series. However, there are also complications associated to this prosthesis. The number of neurological lesions found in RSA in neurophysiological studies have shown to be more frequent than the anatomical shoulder prosthesis. The lengthening of the arm that is provoked with the RSA is been proposed as one of the possible etiological factors that causes an augmentation of the neurological lesions. This lengthening of the arm is due to the descend and medialization of the centre of rotation (COR) of the shoulder that the RSA needs to increase the lever arm of the deltoid to restore the shoulder movement. The descend of the COR causes the lengthening of the arm and it may elongate its neurovascular structures...
The utilization of the reverse shoulder arthroplasty (RSA) has increased due to its good clinical outcomes. These good results have not only been documented in the early postoperative period, but also in mid and long term in clinical series. However, there are also complications associated to this prosthesis. The number of neurological lesions found in RSA in neurophysiological studies have shown to be more frequent than the anatomical shoulder prosthesis. The lengthening of the arm that is provoked with the RSA is been proposed as one of the possible etiological factors that causes an augmentation of the neurological lesions. This lengthening of the arm is due to the descend and medialization of the centre of rotation (COR) of the shoulder that the RSA needs to increase the lever arm of the deltoid to restore the shoulder movement. The descend of the COR causes the lengthening of the arm and it may elongate its neurovascular structures...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Cirugía, leída el 07-11-2019