Cementless humeral head resurfacing for degenerative glenohumeral osteoarthritis fails at a high rate

Traumatic anterior glenohumeral subluxations comprise the majority of glenohumeral instability events and are endemic in young athletes. Unlike the definitive complete dislocation event, subluxation events may often be more subtle in presentation and, therefore, may be overlooked by clinicians. Glenohumeral subluxation events are associated with a high rate of labral tears as well as humeral head defects. While less is known of the natural history of these injuries, young athletes are at risk for recurrent instability events if not properly diagnosed and treated. While reports of surgical treatment outcomes isolated to subluxation events are limited, arthroscopic and open Bankart repair have been shown to result in excellent outcomes. The purpose of this paper is to review the etiology and pathoanatomy of traumatic anterior glenohumeral subluxations as well as to review the appropriate evaluation and management of patients with this injury.

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TOTAL SHOULDER ARTHROPLASTY, AN OVERVIEW, INDICATINS AND PROSTHETIC OPTIONS

Wiadomości Lekarskie ◽

10.36740/wlek202009112 ◽

2020 ◽

Vol 73 (9) ◽

pp. 1870-1873

Author(s):

Mateusz Wicha ◽

Agnieszka Tomczyk-Warunek ◽

Jaromir Jarecki ◽

Anna Dubiel

Keyword(s):

Shoulder Arthroplasty ◽

Humeral Head ◽

Reverse Shoulder Arthroplasty ◽

Total Shoulder Arthroplasty ◽

Shoulder Function ◽

Long Term Result ◽

Glenohumeral Osteoarthritis ◽

Hip Arthroplasties ◽

Reverse Total Shoulder

Shoulder arthroplasty (SA) has improved significantly over the last twenty years. It offers the effective treatment for patients with severe shoulder dysfunctions. The indications for this procedure have recently expanded tremendously. However, the most common are glenohumeral osteoarthritis, inflammatory shoulder arthropathies, rotator cuff-tear arthropathy, complex fractures of the proximal humerus and osteonecrosis of a humeral head. There is range of the procedures, such as resurfacing of humeral head, anatomic total shoulder arthroplasty, hemiarthroplasty and reverse shoulder arthroplasty. All of them could significantly improve patients quality of life. The outcomes of the shoulder arthroplasty are very satisfying in terms of pain relief and considerable improvements in shoulder function as well as in motion. However, this procedure is not so popular as knee or hip arthroplasties. The reasons for this phenomenon are not clear. The complication rate is considerably low. The most common are periprosthetic fractures, infections, implant loosening and instability. The reasonable solution is a conversion to reverse total shoulder arthroplasty. The survivorship of the prosthesis is up to 12 years, which is acceptable by patients. Long term result are still not clear. Surgeons performing SA opt for deltopectoral approach which provides good exposure of the joint also for revisions. The aim: To summarize knowledge about SA based on current literature.

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Determination of humeral head size in anatomic shoulder replacement for glenohumeral osteoarthritis

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2013.09.005 ◽

2014 ◽

Vol 23 (7) ◽

pp. 955-963 ◽

Cited By ~ 38

Author(s):

Ari R. Youderian ◽

Eric T. Ricchetti ◽

Meghan Drews ◽

Joseph P. Iannotti

Keyword(s):

Humeral Head ◽

Head Size ◽

Shoulder Replacement ◽

Glenohumeral Osteoarthritis

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Static posterior subluxation of the humeral head: An unrecognized entity responsible for glenohumeral osteoarthritis in the young adult

Journal of Shoulder and Elbow Surgery ◽

10.1067/mse.2002.124547 ◽

2002 ◽

Vol 11 (4) ◽

pp. 309-314 ◽

Cited By ~ 85

Author(s):

Gilles Walch ◽

Claudio Ascani ◽

Aziz Boulahia ◽

Laurent Nové-Josserand ◽

T.Bradley Edwards

Keyword(s):

Young Adult ◽

Humeral Head ◽

Posterior Subluxation ◽

Glenohumeral Osteoarthritis

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Outcomes of arthroscopic Bankart repair (ABR) for anterior shoulder instability using two knotless suture anchors fixation.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.11.6485 ◽

2021 ◽

Vol 28 (11) ◽

pp. 1595-1599

Author(s):

Sana Ullah ◽

Waqas Haleem ◽

Muhammad Waqar ◽

Zeeshan Khan ◽

Israr Ahmad ◽

...

Keyword(s):

Shoulder Instability ◽

Suture Anchor ◽

Surgical Complication ◽

High Rate ◽

Bankart Repair ◽

Anterior Shoulder Instability ◽

Short Term ◽

Arthroscopic Bankart Repair ◽

Glenohumeral Osteoarthritis ◽

Knotless Suture Anchor

Objectives: The purpose of this study is to evaluate the short term outcomes of isolated Arthroscopic Bankart Repair (ABR) using knotless suture anchor technique, in young and middle aged patients with post traumatic Anterior Shoulder Instability (ASI). Study Design: Prospective Observational Study. Setting: Sports Units of Hayatabad Medical Complex, Peshawar. Period: January 2018 to December 2020. Material & Methods: 32 patients were included in this study, all of them were male, and who had traumatic anterior shoulder dislocation and underwent Arthroscopic Bankart Repair (ABR), with at least 2 years follow-up and minimum of 4 months of physiotherapy postoperatively. Sample size was calculated through non-probability consecutive sampling technique. Recurrent instability, postoperative glenohumeral osteoarthritis, post-surgical complications and subjective scores (Simple Shoulder Test [SST], American Shoulder and Elbow Surgeon [ASES] and Rowe scores) were evaluated. Results: Among the 32 participants, five patients (15.6%) experienced at least one episode of redislocation, eight patients (25%) had moderate to severe glenohumeral-osteoarthritis. The overall satisfaction rate was 76% with ASES, SST and Rowe scores of 82%, 9% and 79% respectively. One patient (3.12%) had wound infection. Conclusion: Isolated Arthroscopic Bankart Repair (ABR) using knotless suture anchor fixation for anterior shoulder instability followed by physiotherapy has excellent short term outcome in term of low post-surgical complication rate, high patient satisfaction, ability to joint work back and improved subjective scores, although high rate of postoperative glenohum eral osteoarthritis is disappointing necessitating further studies on the matter.

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Total shoulder replacement compared with humeral head replacement for the treatment of primary glenohumeral osteoarthritis: A systematic review

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2006.10.017 ◽

2007 ◽

Vol 16 (4) ◽

pp. 396-402 ◽

Cited By ~ 194

Author(s):

Craig S. Radnay ◽

Kevin J. Setter ◽

Locky Chambers ◽

William N. Levine ◽

Louis U. Bigliani ◽

...

Keyword(s):

Systematic Review ◽

Humeral Head ◽

Shoulder Replacement ◽

Total Shoulder Replacement ◽

Glenohumeral Osteoarthritis ◽

Humeral Head Replacement

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Anatomic humeral head replacement with a press-fit prosthesis: An in vivo radiographic study

Orthopedic Reviews ◽

10.4081/or.2017.7168 ◽

2017 ◽

Vol 9 (3) ◽

Author(s):

Bryan Vopat ◽

Jeremy Truntzer ◽

Daniel Aaron ◽

Jack Anavian ◽

Joel Schwartz ◽

...

Keyword(s):

Shoulder Arthroplasty ◽

Humeral Head ◽

Total Shoulder Arthroplasty ◽

Anatomic Reconstruction ◽

Implant Design ◽

Design Parameters ◽

Press Fit ◽

Humeral Component ◽

Glenohumeral Osteoarthritis ◽

The Mean

Successful total shoulder arthroplasty is, in part, dependent on anatomic reconstruction of the glenohumeral joint. The purpose of this study was to evaluate the post-operative anatomy of total shoulder arthroplasty with an anatomic implant design in patients with primary glenohumeral osteoarthritis and compare it to published normative anatomic measurements. Fifty-one patients (56 shoulders) with primary glenohumeral osteoarthritis were treated with a press-fit humeral component as part of a total shoulder arthroplasty (Aequalis, Tornier, Edina, Minnesota). Analysis of postoperative true anterior posterior radiographs was performed with use of a custom software algorithm. The mean humeral inclination (head-shaft angle), mean humeral implant anatomical humeral axis, mean greater tuberosity height, and mean humeral head center offset (medial offset) were 135.4±5.1°, 1.73±1.7°, 6.9±2.4 mm, and 3.8±1.8 mm, respectively. All parameters were within the ranges reported in the literature for normal shoulders except the mean humeral head center offset, which was less than reported in the literature. Anatomic parameters of a total shoulder arthroplasty can be achieved with an anatomically designed, modular adaptable press-fit design. Reduced medial humeral head center offset was likely dependent upon implant specific design parameters.

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Survivorship and Patient-Reported Outcomes After Comprehensive Arthroscopic Management of Glenohumeral Osteoarthritis: Minimum 10-Year Follow-up

The American Journal of Sports Medicine ◽

10.1177/0363546520962756 ◽

2020 ◽

Vol 49 (1) ◽

pp. 130-136

Author(s):

Justin W. Arner ◽

Bryant P. Elrick ◽

Philip-C. Nolte ◽

Daniel B. Haber ◽

Marilee P. Horan ◽

...

Keyword(s):

Risk Factors ◽

Humeral Head ◽

Patient Reported Outcomes ◽

Short Form ◽

Consecutive Series ◽

Long Term Outcome ◽

Arthroscopic Management ◽

Patient Reported ◽

Glenohumeral Osteoarthritis

Background: Few long-term outcome studies exist evaluating glenohumeral osteoarthritis (GHOA) treatment with arthroscopic management. Purpose: To determine outcomes, risk factors for failure, and survivorship for the comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA at minimum 10-year follow-up. Study Design: Case series; Level of evidence, 3. Methods: The CAM procedure was performed on a consecutive series of patients with advanced GHOA who opted for joint preservation surgery and otherwise met criteria for total shoulder arthroplasty. At minimum 10-year follow-up, postoperative outcome measures included change in the American Shoulder and Elbow Surgeons, Single Assessment Numeric Evaluation, 12-Item Short Form Health Survey (SF-12) Physical Component Summary, and visual analog scale for pain, along with the QuickDASH (shortened version of Disabilities of the Arm, Shoulder and Hand) and satisfaction score. Kaplan-Meier survivorship analysis was performed, with failure defined as progression to arthroplasty. Results: In total, 38 CAM procedures were performed with 10-year minimum follow-up (range, 10-14 years) with a mean patient age of 53 years (range, 27-68 years) at the time of surgery. Survivorship was 75.3% at 5 years and 63.2% at minimum 10 years. Those who progressed to arthroplasty did so at a mean 4.7 years (range, 0.8-9.6 years). For those who did not undergo arthroplasty, American Shoulder and Elbow Surgeons scores significantly improved postoperatively at 5 years (63.3 to 89.6; P < .001) and 10 years (63.3 to 80.6; P = .007). CAM failure was associated with severe preoperative humeral head incongruity in 93.8% of failures as compared with 50.0% of patients who did not go on to arthroplasty ( P = .008). Median satisfaction was 7.5 out of 10. Conclusion: Significant improvements in patient-reported outcomes were sustained at minimum 10-year follow-up in young patients with GHOA who underwent a CAM procedure. The survivorship rate at minimum 10-year follow-up was 63.2%. Humeral head flattening and severe joint incongruity were risk factors for CAM failure. The CAM procedure is an effective joint-preserving treatment for GHOA in appropriately selected patients, with sustained positive outcomes at 10 years.

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