Intermediate and long-term follow-up of total shoulder arthroplasty for the management of postcapsulorrhaphy arthropathy

Abstract Introduction Stemmed humeral implants have represented the gold standard in total shoulder arthroplasty (TSA) for decades. Like many other joints, the latest trends in TSA designs aim at bone preservation. Current studies have demonstrated that native proximal humeral bone stresses are most closely mimicked by stemless implants. Nevertheless, there are concerns about the long-term performance of stemless designs. The aim of the present study was to evaluate the long-term radiographic changes at the proximal humerus in anatomical stemless press-fit TSA. Materials and Methods Between 2008 and 2010, 48 shoulders in 43 patients were resurfaced using an anatomic stemless shoulder prosthesis (TESS, Biomet). Thirty shoulders in twenty-five patients who were aged 65.7 ± 9.9 (34 to 82) years were available for clinical and radiographic review at a mean follow-up of 94.0 ± 8.9 (78 to 110) months. Results Radiographic changes of the proximal humerus due to stress shielding were found in 38.4% of the stemless TESS implants. Mild stress shielding accounted for 80% of the observed radiographic changes. Radiographs exhibited stable fixation of the stemless humeral press-fit implant at early and late follow-up. In contrast, radiolucent lines at the glenoid implant were found in 96.1% of the cases. Irrespective of the degree of radiographic changes, clinical scores (VAS, Quick-DASH, Constant score) significantly improved at follow-up. Conclusions The anatomic stemless press-fit implant seems to be favorable in terms of implant-related stress shielding. Clinical outcome was not affected by radiographic changes, demonstrating an 8-year clinical performance that seems to be comparable to conventional stemmed TSA.

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Reverse shoulder arthroplasty: the role of physical therapy on the clinical outcome in the mid-term to long-term follow-up

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-018-3015-9 ◽

2018 ◽

Vol 138 (12) ◽

pp. 1647-1652 ◽

Cited By ~ 1

Author(s):

Stephan Uschok ◽

Sebastian Herrmann ◽

Stephan Pauly ◽

Carsten Perka ◽

Stefan Greiner

Keyword(s):

Physical Therapy ◽

Clinical Outcome ◽

Shoulder Arthroplasty ◽

Reverse Shoulder Arthroplasty ◽

Long Term Follow Up

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Medium to long-term results of a recessed glenoid for glenoid resurfacing in total shoulder arthroplasty

Shoulder & Elbow ◽

10.1177/1758573219826341 ◽

2019 ◽

Vol 12 (1_suppl) ◽

pp. 31-39

Author(s):

Mark Ross ◽

Jean-Marc Glasson ◽

Justin Alexander ◽

Christopher G Conyard ◽

Benjamin Hope ◽

...

Keyword(s):

Clinical Outcomes ◽

Shoulder Arthroplasty ◽

Total Shoulder Arthroplasty ◽

Long Term Results ◽

Shoulder Replacement ◽

Shoulder Hemiarthroplasty ◽

Total Shoulder Replacement ◽

Implant Survivorship

Background Recessed mini-glenoid components provide an alternative to total shoulder replacement that may avoid some of the known shortcomings and complications associated with shoulder hemiarthroplasty or standard glenoid components in difficult cases. This study reports survivorship, radiological and clinical outcomes of a recessed mini-glenoid implant in a consecutive cohort. Methods Retrospective cohort study reporting outcomes of 28 consecutive shoulders (27 patients) following total shoulder replacement using a recessed, cemented mini-glenoid implant at two sites. Results The most frequent diagnosis was primary osteoarthritis (79%); glenoid morphology was Walch Type A (67%), B1 15%, B2 10% and C 10%. At final follow-up, pain was 16.3 (SD = 23.1), American Shoulder and Elbow Score was 64.5 (SD = 31.9) and (normalized) Constant score was 83.0 (SD = 20.7). Implant survivorship at average final follow-up of seven years (3–13) was 96.4%. Seven mini-glenoids showed small peripheral radiolucent lines at one-year X-ray follow-up but were non-progressive on subsequent imaging. Discussion Recessed polyethylene mini-glenoid is an attractive alternative for shoulder arthroplasty and provides an intermediate solution between standard glenoid components and hemiarthroplasty. Our medium to long-term results demonstrate reliable clinical outcomes, absence of glenoid erosion, low complication rate and satisfactory implant survivorship.

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Mid- to Long-Term Follow-Up of Shoulder Arthroplasty for Primary Glenohumeral Osteoarthritis in Patients Aged 60 or Under

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2021.03.037 ◽

2021 ◽

Vol 30 (7) ◽

pp. e432-e433

Author(s):

Lionel Neyton ◽

Jacob Kirsch

Keyword(s):

Shoulder Arthroplasty ◽

Long Term Follow Up ◽

Glenohumeral Osteoarthritis

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Hybrid Glenoid Designs in Anatomic Total Shoulder Arthroplasty: A Systematic Review

HSS Journal ® ◽

10.1177/15563316211040829 ◽

2021 ◽

pp. 155633162110408

Author(s):

Ahmed Haleem ◽

Phelopater Sedrak ◽

Chetan Gohal ◽

George S. Athwal ◽

Moin Khan ◽

...

Keyword(s):

Los Angeles ◽

Shoulder Arthroplasty ◽

Bone Ingrowth ◽

External Rotation ◽

Total Shoulder Arthroplasty ◽

Glenoid Component ◽

Patient Reported

Background: Hybrid glenoid components in total shoulder arthroplasty (TSA) utilize both polyethylene and metal components to provide short-term stability and long-term biologic fixation through bone ingrowth. Questions/Purpose: We sought to systematically review the literature for studies that assessed outcomes of TSA performed using hybrid glenoid components. Methods: PubMed, Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Embase were searched systematically for articles measuring clinical and patient-reported outcomes and rates of complication and revision following TSA using a hybrid glenoid component. Results: Seven studies with 593 shoulders were included in this review. The mean age of patients was 65 ± 1 years, and 46% of the population was male. Mean follow-up was 50 months (4.2 years). The overall complication rate was 7% and rate of revision was 2.5%; glenoid radiolucency was present in 33% of shoulders at mean follow-up of 50 months. Mean improvements in forward elevation, external rotation, internal rotation score, and abduction were 49°, 28°, 2 points, and 42°, respectively. Mean improvements in Constant, American Shoulder and Elbow Surgeons (ASES), and University of California, Los Angeles (UCLA) scores were 36 points, 52 points, and 17 points, respectively. Conclusion: Our review found that TSA using hybrid glenoid components results in low rates of complication and revision at early follow-up. Long-term studies are warranted to understand more fully the role of hybrid glenoid components in TSA.

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