Prosthetic Humeral Head Center of Rotation Shift from Ideal is Associated with Inferior Clinical Outcomes after Anatomic Total Shoulder Arthroplasty

2021 ◽  
Author(s):  
Brian C. Werner ◽  
R. Alexander Creighton ◽  
Patrick J. Denard ◽  
Evan Lederman ◽  
Anthony Romeo ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Total Shoulder Arthroplasty ◽  
Center Of Rotation

scholarly journals Clinical and Radiological Results of Hemiarthroplasty and Total Shoulder Arthroplasty for Primary Avascular Necrosis of the Humeral Head in Patients Less Than 60 Years Old

2021 ◽  
Vol 10 (14) ◽  
pp. 3081
Author(s):  
Anthony Hervé ◽  
Mickael Chelli ◽  
Pascal Boileau ◽  
Gilles Walch ◽  
Luc Favard ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Avascular Necrosis ◽  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Revision Rate ◽  
Total Shoulder Arthroplasty ◽  
Young Patients ◽  
Clinical And Radiological Results ◽  
Glenoid Loosening

Background: Total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) have shown good clinical outcomes in primary avascular necrosis of the humeral head (PANHH) both in short and long terms. The purpose of this study was to assess the complications, the clinical and radiological outcomes of shoulder arthroplasty in young patients with PANHH. Methods: One hundred and twenty-seven patients aged under 60 years old and suffering from PANHH were operated with arthroplasty. Patients were assessed clinically and radiographically before surgery with a minimum of 2 years of follow up (FU). Results: HA was performed on 108 patients (85%). Two patients were revised for painful glenoid wear after 2 and 4 years. TSA was performed on 19 patients (15%). Five TSA had to be revised for glenoid loosening (n = 4) or instability (n = 1). Revision rate was 26% with TSA and 2% with HA. There were no significant differences between HA and TSA in terms of clinical outcomes. Conclusions: With a mean FU of 8 years, HA and TSA improved clinical outcomes of patients with PANHH. HA revisions for painful glenoid wear were rare (2%). The revision rate was excessively high with TSA (26%).

Static posterior humeral head subluxation and total shoulder arthroplasty

2009 ◽  
Vol 18 (4) ◽  
pp. 505-510 ◽  
Author(s):  
Christian Gerber ◽  
John G. Costouros ◽  
Atul Sukthankar ◽  
Sandro F. Fucentese
Keyword(s):  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Total Shoulder Arthroplasty

Early fixation of the humeral component in stemless total shoulder arthroplasty

2022 ◽  
Vol 104-B (1) ◽  
pp. 76-82
Author(s):  
Bart ten Brinke ◽  
Brechtje Hesseling ◽  
Denise Eygendaal ◽  
Max A. Hoelen ◽  
Nina M. C. Mathijssen
Keyword(s):  
Clinical Outcomes ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Future Research ◽  
Dash Score ◽  
Term Survival ◽  
Early Migration ◽  
Humeral Component ◽  
Initial Fixation ◽  
Early Fixation

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.

The role of eccentric and offset humeral head variations in total shoulder arthroplasty

2013 ◽  
Vol 22 (7) ◽  
pp. 886-893 ◽  
Author(s):  
Adam Sassoon ◽  
Bradley Schoch ◽  
Peter Rhee ◽  
Cathy D. Schleck ◽  
William S. Harmsen ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Total Shoulder Arthroplasty

Postarthroscopic Humeral Head Osteonecrosis Treated With Reverse Total Shoulder Arthroplasty

Orthopedics ◽  
2013 ◽  
Vol 36 (3) ◽  
pp. e377-e380 ◽  
Author(s):  
Matthew F. Dilisio ◽  
Jeffrey S. Noble ◽  
Robert H. Bell ◽  
Curtis R. Noel
Keyword(s):  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder

scholarly journals Mid-term outcomes of bony increased offset-reverse total shoulder arthroplasty in the Asian population

2021 ◽  
Vol 24 (3) ◽  
pp. 125-134
Author(s):  
Kirtan Tankshali ◽  
Dong-Whan Suh ◽  
Jong-Hun Ji ◽  
Chang-Yeon Kim
Keyword(s):  
Los Angeles ◽  
Clinical Outcomes ◽  
Shoulder Arthroplasty ◽  
Intraoperative Complications ◽  
Total Shoulder Arthroplasty ◽  
Asian Population ◽  
Reverse Total Shoulder Arthroplasty ◽  
Scapular Notching ◽  
Reverse Total Shoulder

Background: To evaluate clinical and radiological outcomes of bony increased offset-reverse total shoulder arthroplasty (BIO-RSA) in the Asian population at mid-term follow-up.Methods: From June 2012 to August 2017 at a single center, 43 patients underwent BIO-RSA, and 38 patients with a minimum of 2 years of follow-up were enrolled. We evaluated the preoperative and postoperative clinical outcomes, radiological outcomes (notching and loosening), and complications of BIO-RSA at the last follow-up. In addition, we divided these patients into notching and not-notching groups and compared the demographics, preoperative, and postoperative characteristics of patients between the two groups.Results: Visual analog scale, American Shoulder and Elbow Surgeons, University of California-Los Angeles, and Simple Shoulder Test scores improved significantly from preoperative (average: 5, 39.43, 16.22, 3.94) to postoperative (average: 1.71, 78.91, 28.34, 7.8; p<0.05) outcomes. All range of motion except internal rotation improved significantly at the final follow-up (p<0.05), and the bone graft was well-incorporated with the native glenoid in all patients (100%). However, scapular notching was observed in 20/38 patients (53%). In the comparison between notching and not-notching groups (18 vs. 20 patients), there were no significant differences in demographics, radiological parameters, and clinical outcomes except acromion-greater tuberosity (AT) distance (p=0.003). Intraoperative complications were three metaphyseal fractures and one inferior screw malposition. Postoperative complications included one heterotopic ossification, one scapula neck stress fracture, one humeral stem loosening, and one late infection.Conclusions: BIO-RSA resulted in improved clinical outcomes at mid-term follow-up in the Asian population. Although better cosmesis and advantages of glenoid lateralization were observed, we observed higher rates of scapular notching compared to previously reported rates in BIO-RSA studies. In addition, adequate glenoid lateralization with appropriate humeral lengthening (AT distance) might reduce scapular notching.

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