scholarly journals Journey of the glenoid in anatomic total shoulder replacement

2018 ◽  
Vol 11 (2) ◽  
pp. 140-148 ◽  
Author(s):  
Alessandro Castagna ◽  
Raffaele Garofalo
Keyword(s):  
Shoulder Arthroplasty ◽  
Current Practice ◽  
Total Shoulder Arthroplasty ◽  
Shoulder Function ◽  
Patient Specific ◽  
Glenoid Component ◽  
Shoulder Replacement ◽  
Final Destination ◽  
Component Loosening

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.

scholarly journals Glenoid Component Loosening in Anatomic Total Shoulder Arthroplasty: Association between Radiological Predictors and Clinical Parameters—An Observational Study

2021 ◽  
Vol 10 (2) ◽  
pp. 234
Author(s):  
Alexandra Grob ◽  
Florian Freislederer ◽  
Alex Marzel ◽  
Laurent Audigé ◽  
Hans-Kaspar Schwyzer ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Mixed Model ◽  
Constant Score ◽  
Total Shoulder Arthroplasty ◽  
Shoulder Function ◽  
Glenoid Component ◽  
Joint Gap ◽  
Acromiohumeral Distance ◽  
One Year ◽  
Component Loosening

The mechanisms of glenoid component loosening in anatomic total shoulder arthroplasty (aTSA) are still unclear, and it remains undetermined which specific radiographic features are associated with clinical outcomes. Patients with primary osteoarthritis who underwent aTSA with a stemless implant and a pegged glenoid between January 2011 and December 2016 were extracted from a local registry. Anteroposterior radiographs were evaluated at six, 12, 24 months, and five years post-TSA for lateral humeral offset (LHO), joint gap (JG), acromiohumeral distance (AHD), and radiolucency (modified Franklin score); 147 patients were included. Mixed-model linear regression was used. Both constant score (CS) and subjective shoulder value (SSV) markedly decreased at five years follow-up compared to one year (p < 0.001 for both). AHD, LHO, and JG all showed a consistent and statistically significant decline over time, with the joint gap decreasing by half. Consistently, smaller JG and AHD were correlated with lower SSV (p = 0.03 and p = 0.07, respectively). Massive loosening was associated with a 14.5 points lower SSV (p < 0.01). Finally, narrowing of the JG was significantly correlated with increased radiolucency (p < 0.001) and tended toward worse SSV (p = 0.06). In summary, radiographic parameters displaying medialization and cranialization after aTSA with a cemented pegged glenoid are useful predictors of impaired shoulder function.

Glenoid bone grafting in primary anatomic total shoulder arthroplasty: a systematic review

2020 ◽  
pp. 175857322091765
Author(s):  
Betty Zhang ◽  
Gavinn Niroopan ◽  
Chetan Gohal ◽  
Bashar Alolabi ◽  
Timothy Leroux ◽  
...  
Keyword(s):  
Bone Loss ◽  
Shoulder Arthroplasty ◽  
Bone Grafting ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Level Of Evidence ◽  
Total Shoulder Arthroplasties ◽  
Component Loosening ◽  
Shoulder Arthroplasties

Background Primary anatomic total shoulder arthroplasty can be challenging in patients with complex glenoid wear patterns and bone loss. Severe retroversion (>15°) or significant bone loss may require bone grafting. This review summarizes the rate of revision and long-term outcomes of anatomic total shoulder arthroplasty with bone graft. Methods A systematic search of MEDLINE, Embase, PubMed, and CENTRAL databases was conducted from the date of inception to 23 October 2018. Two reviewers independently screened articles for eligibility and extracted data for analysis. The primary outcome was rate of revision. The secondary outcomes were rate of component loosening, functional outcome, and range of motion. Results Of the 1056 articles identified in the search, 26 underwent full-text screening and 7 articles were included in the analysis. All procedures were one-stage anatomic total shoulder arthroplasties. The rate of revision was 5.4% with component loosening and infection listed as indications over a weighted mean follow-up period of 6.3 years. Complications occurred in 12.6% of patients. Conclusion Glenoid bone grafting in anatomic total shoulder arthroplasty results in comparable revision rates and improvement in pain compared to augmented glenoid components and reverse shoulder arthroplasty. Due to the low quality of evidence, further prospective studies should be conducted. Level of evidence IV

Quantitative Assessment of Glenohumeral Joint Forces in Positions of Overhead Activities: Effects of Shoulder Arthroplasty

2002 ◽  
Author(s):  
Thay Q. Lee ◽  
Mark Schamblin ◽  
Bruce Y. Yang ◽  
Michelle H. McGarry ◽  
Ranjan Gupta
Keyword(s):  
Shoulder Arthroplasty ◽  
Glenohumeral Joint ◽  
Total Shoulder Arthroplasty ◽  
Glenoid Component ◽  
Shoulder Hemiarthroplasty ◽  
Adequate Pain Relief ◽  
Joint Forces ◽  
Before And After ◽  
Total Knee ◽  
Component Loosening

Glenohumeral arthroplasty as well as hemiarthroplasty, although providing adequate pain relief, has not shared in the success of similar joint replacement procedures such as total knee arthroplasty or total hip arthroplasty. Short comings of this procedure include a decreased range of motion postoperatively as well as increased incidents of glenoid component loosening in total shoulder procedures. This is especially a problem in the end ranges of motion where eccentric loading of the glenoid component are thought to occur. The purpose of this study was to quantify the glenohumeral joint forces before and after bipolar shoulder hemiarthroplasty and total shoulder arthroplasty for positions simulating overhead activities and commonly relied upon by the wheelchair dependent individual.

A comparison of onlay versus inlay glenoid component loosening in total shoulder arthroplasty

2017 ◽  
Vol 26 (7) ◽  
pp. 1113-1120 ◽  
Author(s):  
Jeffrey R. Gagliano ◽  
Sarah M. Helms ◽  
Gregory P. Colbath ◽  
Breanne T. Przestrzelski ◽  
Richard J. Hawkins ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Glenoid Component ◽  
Component Loosening

Effect of Glenoid Implant Orientation and Depth on Potential Cement Failure in Total Shoulder Arthroplasty Using Finite Element Analysis

2012 ◽  
Author(s):  
Charlie Yongpravat ◽  
William N. Levine ◽  
Louis U. Bigliani ◽  
Thomas R. Gardner ◽  
Christopher S. Ahmad
Keyword(s):  
Finite Element Analysis ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Cement Mantle ◽  
Glenoid Component ◽  
Fixation Failure ◽  
Element Analysis ◽  
Component Loosening ◽  
Glenoid Erosion ◽  
Glenoid Retroversion

One of the most common complications of total shoulder arthroplasty (TSA) is glenoid component loosening due to implant-cement fixation failure. High cement stresses resulting in fracture are believed to result from malpositioning the glenoid implant [1]. Ideal glenoid preparation and placement, however, are not always achievable due to significant anatomical alterations caused by arthritis resulting in posterior glenoid erosion and increased glenoid retroversion. To our knowledge, prior research has not compared the effects of insufficient reaming depth and incomplete version correction on the likelihood of cement mantle failure. The purpose of this study was to investigate how the degree of correction of the glenoid vault affects cement mantle stress and potential cement failure.

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

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.

scholarly journals Short-Term Outcomes of the Grammont Reverse Shoulder Arthroplasty: Comparison between First and Second Generation Delta Prosthesis

Joints ◽  
2021 ◽  
Author(s):  
Riccardo Luigi Alberio ◽  
Marco Landrino ◽  
Paolo Fornara ◽  
Federico Alberto Grassi
Keyword(s):  
Shoulder Arthroplasty ◽  
Second Generation ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Radiographic Evaluation ◽  
Glenoid Component ◽  
Consecutive Series ◽  
Short Term ◽  
Component Loosening

Abstract Purpose This article compares short-term outcomes of two series of patients, who underwent reverse total shoulder arthroplasty (RTSA) with two different implants, both based on Grammont's principles: the Delta III (D-3) and the Delta Xtend (D-XT) prostheses. Methods The D-3 group included a consecutive series of 26 patients (mean age 75 years), that were treated between 2000 and 2006; the D-XT group included a consecutive series of 31 patients (mean age 72.5 years), for a total of 33 implants performed between 2011 and 2015. In both groups the most common diagnoses were cuff tear arthropathy (18 and 22 shoulders, respectively) and malunion of proximal humerus fractures (3 and 5). All procedures were performed by the same surgeon. Constant–Murley score (CMS) was used to assess clinical and functional outcomes. Radiographic evaluation included the true anteroposterior and axillary views. Results Twenty-three patients of the D-3 group and 22 patients (24 shoulders) of the D-XT group were evaluated at a mean follow-up of 42 months (range 26–84) and 44 months (range 26–66), respectively. Four complications occurred in the D-3 group (1 partial deltoid detachment, 1 dislocation, and 2 glenoid component loosening), while one early postoperative infection occurred in the D-XT group. Increases in elevation and CMS between preoperative and postoperative period were observed in both groups; only the D-XT group showed a slight improvement in rotations. The incidence of scapular notching was significantly different between the two groups: 100% for D-3 and 22.2% for D-XT in patients with a minimum follow-up of 5 years. Conclusion Prosthetic design evolution and greater acquaintance with this surgery have undoubtedly led to an improvement in short-term outcomes with second generation implants of RTSA. Future studies will have to ascertain whether newer implants, relying on biomechanical solutions alternative to Grammont's original concept, might provide additional advantages and minimize drawbacks.

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