Mid-term results of anatomical total shoulder arthroplasty for primary osteoarthritis using a short-stemmed cementless humeral component

2018 ◽  
Vol 100-B (5) ◽  
pp. 603-609 ◽  
Author(s):  
M. Schnetzke ◽  
S. Rick ◽  
P. Raiss ◽  
G. Walch ◽  
M. Loew
Keyword(s):  
Cortical Bone ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Bone Adaptation ◽  
Filling Ratio ◽  
Short Stem ◽  
Primary Osteoarthritis ◽  
Humeral Component ◽  
High Bone

Aims The aim of this study was to evaluate the clinical and radiological outcome of using an anatomical short-stem shoulder prosthesis to treat primary osteoarthritis of the glenohumeral joint. Patients and Methods A total of 66 patients (67 shoulders) with a mean age of 76 years (63 to 92) were available for clinical and radiological follow-up at two different timepoints (T1, mean 2.6 years, sd 0.5; T2, mean 5.3 years, sd 0.7). Postoperative radiographs were analyzed for stem angle, cortical contact, and filling ratio of the stem. Follow-up radiographs were analyzed for timing and location of bone adaptation (cortical bone narrowing, osteopenia, spot welds, and condensation lines). The bone adaptation was classified as low (between zero and three features of bone remodelling around the humeral stem) or high (four or more features). Results The mean Constant score improved significantly from 28.5 (sd 11.6) preoperatively to 75.5 (sd 8.5) at T1 (p < 0.001) and remained stable over time (T2: 76.6, sd 10.2). No stem loosening was seen. High bone adaptation was present in 42% of shoulders at T1, with a slight decrease to 37% at T2. Cortical bone narrowing and osteopenia in the region of the calcar decreased from 76% to 66% between T1 and T2. Patients with high bone adaptation had a significantly higher mean filling ratio of the stem at the metaphysis (0.60, sd 0.05 vs 0.55, sd 0.06; p = 0.003) and at the diaphysis (0.65 sd 0.05 vs 0.60 sd 0.05; p = 0.007). Cortical contact of the stem was also associated with high bone adaptation (14/25 shoulders, p = 0.001). The clinical outcome was not influenced by the radiological changes. Conclusion Total shoulder arthroplasty using a short-stem humeral component resulted in good clinical outcomes with no evidence of loosening. However, approximately 40% of the shoulders developed substantial bone loss in the proximal humerus at between four and seven years of follow-up. Cite this article: Bone Joint J 2018;100-B:603–9.

Total Shoulder Arthroplasty for Primary Osteoarthritis Utilizing a Mini-Stem Humeral Component- Midterm Results of the First 100 Cases

2015 ◽  
Vol 24 (4) ◽  
pp. e116 ◽  
Author(s):  
Elizabeth Gausden ◽  
Samuel A. Taylor ◽  
Joshua S. Dines ◽  
Asheesh Bedi ◽  
Christopher Chin ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Midterm Results ◽  
Primary Osteoarthritis ◽  
Humeral Component

Clinical and radiologic outcomes following total shoulder arthroplasty using Arthrex Eclipse stemless humeral component with minimum 2 years' follow-up

2018 ◽  
Vol 27 (12) ◽  
pp. 2191-2197 ◽  
Author(s):  
Sian Gallacher ◽  
Huw L.M. Williams ◽  
Andrew King ◽  
Jeff Kitson ◽  
Chris D. Smith ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Humeral Component

Short-term clinical outcome of an anatomic short-stem humeral component in total shoulder arthroplasty

2018 ◽  
Vol 27 (1) ◽  
pp. 70-74 ◽  
Author(s):  
Anthony A. Romeo ◽  
Robert J. Thorsness ◽  
Shelby A. Sumner ◽  
Reuben Gobezie ◽  
Evan S. Lederman ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Short Stem ◽  
Short Term ◽  
Humeral Component

Radiographic evaluation of short-stem press-fit total shoulder arthroplasty: short-term follow-up

2016 ◽  
Vol 25 (7) ◽  
pp. 1163-1169 ◽  
Author(s):  
Danielle J. Casagrande ◽  
Di L. Parks ◽  
Travis Torngren ◽  
Mark A. Schrumpf ◽  
Samuel M. Harmsen ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Short Stem ◽  
Radiographic Evaluation ◽  
Short Term ◽  
Press Fit

Three-Dimensional Volumetric Filling Ratio Predicts Stress Shielding in Short Stem Anatomic Total Shoulder Arthroplasty

2020 ◽  
Vol 29 (4) ◽  
pp. e163-e166
Author(s):  
Haluk Celik ◽  
Aakash Chauhan ◽  
Cesar Flores-Hernandez ◽  
Daryl D’Lima ◽  
Heinz Hoenecke
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Three Dimensional ◽  
Stress Shielding ◽  
Filling Ratio ◽  
Short Stem

Anatomic short-stem humeral component in total shoulder arthroplasty: a retrospective analysis

2020 ◽  
Author(s):  
Christopher Hadley ◽  
Michael J. Gutman ◽  
Meghan E. Bishop ◽  
Surena Namdari ◽  
Brandon J. Erickson ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Short Stem ◽  
Humeral Component

scholarly journals Treatment Outcomes of Lesser Tuberosity Osteotomy Nonunion After Total Shoulder Arthroplasty

2018 ◽  
Vol 2 ◽  
pp. 247154921880777
Author(s):  
Zachary J Bloom ◽  
Cesar D Lopez, BA ◽  
Stephen P Maier ◽  
Brian B Shiu ◽  
Djuro Petkovic ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Shoulder Arthroplasty ◽  
Surgical Repair ◽  
Total Shoulder Arthroplasty ◽  
Case Series ◽  
Radiographic Evaluation ◽  
Lesser Tuberosity ◽  
Conservative Care ◽  
Conservative Group

Introduction Lesser tuberosity osteotomy (LTO) during anatomic total shoulder arthroplasty has a 13% nonunion rate. Treatment for LTO nonunion is controversial and poorly described in the literature. The purpose of this study was to compare the surgical and nonsurgical treatment outcomes of LTO nonunion. Methods A retrospective case series of 9 consecutive patients with LTO nonunion after primary anatomic shoulder arthroplasty at 1 institution from 2010 to 2016 were studied. Outcomes measured were radiographic evaluation of LTO on axillary X-ray, clinical range of motion (ROM), subscapularis strength, and pain at the time of LTO nonunion diagnosis and after either conservative care or surgical repair of the LTO nonunion. Results LTO nonunion was treated surgically in 4 and conservatively in 5 patients with average follow-up of 30 and 22 months, respectively. There were no significant differences in age, sex, or smoking status between groups. Treatment decision was a shared model of surgeon and patient. Displaced LTO nonunion was treated surgically in 2 and conservatively in 3 patients. There were no differences in LTO union rate of 50% in the surgical versus 60% in the conservative group. Abdominal compression test was abnormal in 50% of surgical versus 40% of conservative groups. At follow-up, ROM was lower in the surgical group with 128° forward elevation (FE) and 33° external rotation (ER) compared to 148° FE and 62° ER. Only 1 patient with LTO nonunion required conversion to reverse replacement. Conclusion LTO nonunion after shoulder arthroplasty is rare. Surgical repair of LTO nonunion does not significantly improve clinical or radiographic outcomes compared to conservative care.

Complication and revision rates after reverse total shoulder revision from hemiarthroplasty: a systematic review

2021 ◽  
pp. 175857322110193
Author(s):  
Arjun K Reddy ◽  
Jake X Checketts ◽  
B Joshua Stephens ◽  
J Michael Anderson ◽  
Craig M Cooper ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Arthroplasty ◽  
Revisional Surgery ◽  
Total Shoulder Arthroplasty ◽  
Surgical Site Infections ◽  
Total Sample ◽  
Reverse Total Shoulder Arthroplasty ◽  
Common Complication ◽  
Humeral Component ◽  
Reverse Total Shoulder

Background Thus, the purpose of the present study was to (1) characterize common postoperative complications and (2) quantify the rates of revision in patients undergoing hemiarthroplasty to reverse total shoulder arthroplasty revisional surgery. We hypothesize that hardware loosenings will be the most common complication to occur in the sample, with the humeral component being the most common loosening. Methods This systematic review adhered to PRISMA reporting guideline. For our inclusion criteria, we included any study that contained intraoperative and/or postoperative complication data, and revision rates on patients who had undergone revision reverse total shoulder arthroplasty due to a failed hemiarthroplasty. Complications include neurologic injury, deep surgical site infections, hardware loosening/prosthetic instability, and postoperative fractures (acromion, glenoid, and humeral fractures). Results The study contained 22 studies that assessed complications from shoulders that had revision reverse total shoulder arthroplasty from a hemiarthroplasty, with a total sample of 925 shoulders. We found that the most common complication to occur was hardware loosenings (5.3%), and of the hardware loosenings, humeral loosenings (3.8%) were the most common. The revision rate was found to be 10.7%. Conclusion This systematic review found that revision reverse total shoulder arthroplasty for failed hemiarthroplasty has a high overall complication and reintervention rates, specifically for hardware loosening and revision rates.

Anatomic Total Shoulder Arthroplasty With a Stemless Humeral Component

2021 ◽  
Vol 1 (3) ◽  
pp. 263502542199712
Author(s):  
Jordan D. Walters ◽  
Stephen F. Brockmeier
Keyword(s):  
Bone Quality ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Complication Rates ◽  
Lesser Tuberosity ◽  
Critical Elements ◽  
Implant Placement ◽  
Humeral Component ◽  
Component Loosening ◽  
Deltopectoral Approach

Background: This technique video reviews anatomic total shoulder arthroplasty (TSA) with a stemless humeral component using a representative case example. Indications: Stemless TSA is indicated for patients with symptomatic glenohumeral arthritis typically younger than 65 years of age. Stemless TSA may be used for other glenohumeral degenerative conditions such as avascular necrosis or posttraumatic arthropathy, provided acceptable humeral bone quality is confirmed intraoperatively using a thumb-press test. Poor bone quality is the primary contraindication. Technique Description: Preoperatively, computed tomography is typically used for planning, and intraoperative navigation through magnetic resonance imaging is also useful. The procedure’s critical elements include beach chair positioning, standard deltopectoral approach with lesser tuberosity osteotomy (LTO), freehand proximal humeral osteotomy, perpendicular proximal humeral exposure and subsequent preparation over a central guidewire, stemless implant and humeral head sizing, perpendicular glenoid exposure and implant placement, and final humeral implantation with LTO repair/fixation. A phased rehabilitation protocol includes 6-week sling immobilization to protect the subscapularis/LTO repair and return to normal activities between 3 and 6 months postoperatively. Discussion/Conclusion: Stemless TSA shows promising early and mid-term outcomes with complication rates, including humeral loosening rates, similar to standard stemmed components. Potential complications include neurovascular injury, infection, glenoid or humeral component loosening, and rotator cuff failure.

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