Anatomic total shoulder arthroplasty with an inlay glenoid component: clinical outcomes and return to activity

2020 ◽  
Vol 29 (6) ◽  
pp. 1188-1196 ◽  
Author(s):  
Gregory L. Cvetanovich ◽  
Amanda J. Naylor ◽  
Michael C. O'Brien ◽  
Brian R. Waterman ◽  
Grant H. Garcia ◽  
...  
10.29007/kld9 ◽  
2019 ◽  
Author(s):  
Alexander Greene ◽  
Sandrine Polakovic ◽  
Christopher Roche ◽  
Yifei Dai

Accurate reproduction of glenohumeral anatomy during anatomic total shoulder arthroplasty (aTSA) has been shown to correlate with positive clinical outcomes. Preoperative planning and computer assisted surgery (CAS) can improve upon glenoid placement, but such systems for aTSA have experienced limited commercial success. Postoperative surgical reports from the first 574 clinical cases of a commercially available CAS aTSA system were collected and analyzed for implant selection, implant placement, and incision start to incision close operative time, and compared to similar date cohorts for non-navigated cases. Navigated aTSA cases had a significantly longer incision time than non-navigated cases. Augmented glenoid components were used in a much higher percentage of navigated cases than non-navigated cases, suggesting that augmented glenoid components provide utility for correcting pathologic glenoid wear. The average resultant version of the implanted component increased with the size of augment used, suggesting there may not be a clear consensus on optimal retroversion. term clinical follow up will need to be collected to determine if preoperative planning combined with more precise and accurate glenoid component positioning leads to improved clinical outcomes and implant longevity.


2013 ◽  
Vol 95 (24) ◽  
pp. 2205-2212 ◽  
Author(s):  
Anastasios Papadonikolakis ◽  
Moni Blazej Neradilek ◽  
Frederick A Matsen

2018 ◽  
Vol 11 (2) ◽  
pp. 140-148 ◽  
Author(s):  
Alessandro Castagna ◽  
Raffaele Garofalo

Anatomic total shoulder arthroplasty (TSR) has been shown to generate good to excellent results for patients with osteoarthritis and a functioning rotator cuff. Many studies have reported that the glenoid component loosening and failure remain the most common long-term complication of total shoulder arthroplasty. The approach to glenoid component is critical because a surgeon should consider patient-specific anatomy, preserving bone stock and joint line restoration, for a good and durable shoulder function. Over the years, different glenoid design and materials have been tried in various configurations. These include cemented polyethylene, uncemented metal-backed and hybrid implants. Although advances in biomechanics, design and tribology have improved our understanding of the glenoid, the journey of the glenoid component in anatomic total shoulder arthroplasty has not yet reached its final destination. This article attempts to describe the evolution of the glenoid component in anatomic TSR and current practice.


2022 ◽  
Vol 104-B (1) ◽  
pp. 76-82
Author(s):  
Bart ten Brinke ◽  
Brechtje Hesseling ◽  
Denise Eygendaal ◽  
Max A. Hoelen ◽  
Nina M. C. Mathijssen

Aims Stemless humeral implants have been developed to overcome stem-related complications in total shoulder arthroplasty (TSA). However, stemless implant designs may hypothetically result in less stable initial fixation, potentially affecting long-term survival. The aim of this study is to investigate early fixation and migration patterns of the stemless humeral component of the Simpliciti Shoulder System and to evaluate clinical outcomes. Methods In this prospective cohort study, radiostereometric analysis (RSA) radiographs were obtained in 24 patients at one day, six weeks, six months, one year, and two years postoperatively. Migration was calculated using model-based RSA. Clinical outcomes were evaluated using the visual analogue scale (VAS), the Oxford Shoulder Score (OSS), the Constant-Murley Score (CMS), and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Results At two years, median translation along the x-, y-, and z-axis was -0.12 mm (interquartile range (IQR) -0.18 to 0.02), -0.17 mm (IQR -0.27 to -0.09), and 0.09 mm (IQR 0.02 to 0.31). Median rotation around the x-, y-, and z-axis was 0.12° (IQR -0.50 to 0.57), -0.98° (IQR -1.83 to 1.23), and 0.09° (IQR -0.76 to 0.30). Overall, 20 prostheses stabilized within 12 months postoperatively. Four prostheses showed continuous migration between 12 and 24 months. At two-year follow-up, with the exception of one revised prosthesis, all clinical scores improved significantly (median VAS difference at rest: -3.0 (IQR -1.5 to -6.0); OSS 22.0 (IQR 15.0 to 25.0); CMS 29.5 (IQR 15.0 to 35.75); and DASH -30.0 (IQR -20.6 to -41.67) (all p < 0.001)) with the exception of one revised prosthesis. Conclusion In conclusion, we found that 20 out of 24 implants stabilized within 12 months postoperatively. The significance of continuous migration in four implants is unclear and future research on the predictive value of early migration for future loosening in TSA is required. Clinical results revealed a clinically relevant improvement. Cite this article: Bone Joint J 2022;104-B(1):76–82.


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