Outcomes of anatomic shoulder arthroplasty in primary osteoarthritis in type B glenoids

Chin, Paul C.; Hachadorian, Michael E.; Pulido, Pamela A.; Munro, Michelle L.; Meriç, Gökhan; Hoenecke, Heinz R.

doi:10.1016/j.jse.2015.05.052

Cited by 40 publications

(37 citation statements)

References 24 publications

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“… 31 Recent reports using CT scans to evaluate preoperative glenoid retroversion have also shown no clinical differences. 4 We observed that the change in retroversion was not associated with better clinical outcomes and that final clinical outcomes were not dependent on postoperative glenoid retroversion.…”

Section: Discussionmentioning

confidence: 56%

“… 37 The B2 glenoid, with posterior glenoid wear and posterior humeral head subluxation, may have inferior biomechanics, poor clinical outcomes, increased complications, and increased rates of glenoid loosening. 16 , 38 Surgical techniques have been introduced to correct glenoid retroversion, including asymmetric reaming of the glenoid, 4 , 7 , 38 augmented glenoid components, 29 , 40 and bone grafting. 17 , 30 , 34 Clinical studies have shown that outcomes may still not be satisfactory.…”

mentioning

confidence: 99%

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Do glenoid retroversion and humeral subluxation affect outcomes following total shoulder arthroplasty?

Benjamin¹,

Xiao²,

Salesky³

et al. 2020

JSES International

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Background Glenoid retroversion and humeral head subluxation have been suggested to lead to inferior outcomes after total shoulder arthroplasty (TSA). There are limited data to support this suggestion. We investigated whether preoperative glenoid retroversion and humeral head subluxation are associated with inferior outcomes after TSA and whether change of retroversion influences outcomes after TSA. Methods Patients undergoing TSA with minimum 2-year follow-up were included from a prospectively collected institutional shoulder arthroplasty database. Retroversion and humeral head subluxation before and after surgery were measured on axillary radiographs. Postoperative radiographs were -evaluated for glenoid component loosening and compared between groups. Spearman correlations were determined between retroversion measurements and American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) scores. Patients were analyzed in groups based on retroversion and humeral head subluxation. Results There were 113 patients (50% follow-up rate) evaluated at 4.2 years postoperatively. The mean preoperative retroversion (15.3° ± 7.7°) was significantly higher than postoperative retroversion (10.0° ± 6.8°; P < .0001). There was no correlation between postoperative glenoid version or humeral head subluxation and ASES scores. For patients with preoperative retroversion of >15°, there was no difference in outcome scores based on postoperative retroversion. There were no differences in preoperative or postoperative version for patients with or without glenoid lucencies. Discussion We observed no significant relationship between postoperative glenoid retroversion or humeral head subluxation and clinical outcomes in patients following TSA. For patients with preoperative retroversion >15°, change of retroversion during TSA had no impact on their clinical outcomes at short-term follow-up.

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Section: Discussionmentioning

confidence: 56%

mentioning

confidence: 99%

Do glenoid retroversion and humeral subluxation affect outcomes following total shoulder arthroplasty?

Benjamin¹,

Xiao²,

Salesky³

et al. 2020

JSES International

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“…Our study had 2 revision operations for glenoid implant loosening (3.9%). Chin et al 1 had 1 revision for glenoid loosening in 37 TSAs (1.1%) done for B1 and B2 glenoids at 5 years postoperation. Furthermore, Orvets et al did not have any revisions for glenoid loosening in 59 shoulders at a mean follow-up of 50 months.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have reported rates of radiographic lucency with this surgical technique without establishing its impact at this time of follow-up. 1 , 18 The primary goal of this study was to identify any clinical improvement in patients with B2 glenoids who underwent minimal corrective reaming at a mean of 4.9 years.…”

Section: Discussionmentioning

confidence: 99%

Total shoulder arthroplasty outcomes after noncorrective, concentric reaming of B2 glenoids

Grantham¹,

Dekker²,

Lacheta³

et al. 2020

JSES International

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Background Total shoulder arthroplasty (TSA) is an effective procedure for the treatment of glenohumeral osteoarthritis (GHOA) delivering reliable pain relief and improved shoulder function. Abnormal glenoid morphologies are common, and biconcave glenoids are enigmas that have been associated with poor clinical outcomes and implant survivorship. Purpose To assess the clinical outcome scores of patients who underwent noncorrective, concentric reaming for TSA with biconcave glenoids (B2). We hypothesized that patients with B2 glenoids who underwent TSA with glenoid implantation using noncorrective, concentric reaming would have significant improvements in clinical outcome scores and high implant survivorship. Methods All patients who underwent anatomic TSA for GHOA with B2 glenoids, performed by a single surgeon, between July 2006 and December 2015 with minimum 2-year follow-up were reviewed. Walch classification was obtained from preoperative imaging (magnetic resonance imaging or computed tomography). Clinical outcome scores were prospectively collected and included American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) score, Single Assessment Numerical Evaluation (SANE) score, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, 12-Item Short Form Health Survey physical component summary (PCS), and patient satisfaction. Clinical failures (revision TSA surgery or conversion to reverse TSA) and complications were reported. Paired t test and bivariate correlations level of significance was set at P = .05. Survivorship analysis with implant failure as an endpoint was done using Kaplan-Meier survival curves. Results 51 TSA in 49 patients (9 females, 40 males) with primary GHOA with B2 glenoids were performed with a mean age of 64 (range 36-81 years) at the time of surgery. The mean retroversion was 19.1° (range 5.4°-38°), and posterior decentering was 42.0% (range 19.4%-78.5%). At final evaluation, 45/51 anatomic TSAs (88% follow-up) with a mean follow-up of 4.9 years (range 2.0-10.4 years) were assessed. All clinical outcome scores improved significantly pre- to postoperatively: ASES, 52.5 to 79.6 ( P < .001); SANE, 52.4 to 74.7 ( P < .001); QuickDASH, 39.2 to 19.1 ( P = .001); and PCS, 40.9 to 48.9 ( P = .001). Median postoperative satisfaction was 9 (range 1-10). There were 2 failures and 4 that required another surgery —subscapularis repair, lysis of adhesions, irrigation and débridement, and one to explore the status of the subscapularis for persistent pain. The implant survivorship rate was 95% at a mean follow-up of 4.9 years. Conclusion Anatomic total shoulder replacement with minimally noncorrective, concentric reaming in patients with B2 glenoids had significant improvement ...

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“…In a retrospective case review, Walch and colleagues analyzed 92 TSAs performed for a B2 glenoid at a mean follow-up of 77 months and observed a 21 % rate of glenoid loosening, which was positively correlated with posterior wear and subluxation [51]. Chin and colleagues confirmed these findings, demonstrating 48 % glenoid component radiolucencies at mean 60-months follow-up in 37 B2 glenoids that underwent TSA [52]. Mizuno and colleagues analyzed 27 RTSA performed for a glenohumeral osteoarthritis with an intact rotator cuff in the setting of a B2-type glenoid with a mean follow-up of 54 months, finding significant improvement in range of motion (mean final AFE of 152°) and functional outcomes (mean final Constant score of 76 points), with a 15 % complication rate and a 4 % re-operation rate [53•].…”

Section: Glenohumeral Osteoarthritis With An Intact Rotator Cuffmentioning

confidence: 93%

Expanding roles for reverse shoulder arthroplasty

Chalmers

Keener

2016

Curr Rev Musculoskelet Med

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Since its introduction in the USA in 2003, reverse total shoulder arthroplasty (RTSA) has been used with increasingly frequency as surgeons have observed the remarkable improvement in pain, range of motion, and function associated with this implant. RTSA was initially used exclusively for elderly, low demand individuals with end-stage rotator cuff tear arthropathy. However, RTSA is now being increasingly successfully employed for the management of irreparable rotator cuff tears, glenohumeral osteoarthritis with an intact rotator cuff, acute proximal humerus fractures, the sequelae of proximal humerus fractures, neoplasms of the proximal humerus, inflammatory arthropathy, young patients and failed anatomic total shoulder arthroplasty and hemiarthroplasty. While long-term outcomes are pending, short-and mid-term follow-up results suggest that in experienced hands, RTSA may be a reasonable treatment for many previously difficult to treat pathologies within the shoulder.

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Outcomes of anatomic shoulder arthroplasty in primary osteoarthritis in type B glenoids

Cited by 40 publications

References 24 publications

Do glenoid retroversion and humeral subluxation affect outcomes following total shoulder arthroplasty?

Do glenoid retroversion and humeral subluxation affect outcomes following total shoulder arthroplasty?

Total shoulder arthroplasty outcomes after noncorrective, concentric reaming of B2 glenoids

Expanding roles for reverse shoulder arthroplasty

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