Reliability of stemless shoulder arthroplasty in rheumatoid arthritis: observation of early lysis around the humeral component

Jordan, Robert W.; Manoharan, Gopikanthan; Liefland, M Van; Dodenhoff, Ron; Hay, Stuart; Kelly, Cormac; Potter, R

doi:10.1007/s12306-019-00629-8

Cited by 4 publications

(3 citation statements)

References 35 publications

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“…This might be a concern after arthroplasty in patients with RA, regardless of implant type. 28,29 In our cohort, the partial ulna head prothesis was mainly inserted in patients with RA and since bone resorption was more pronounced after total ulna head prothesis, this phenomenon seemed to be more influenced by the concept and design of the prothesis rather than by the underlying diagnosis.…”

Section: Discussionmentioning

confidence: 83%

Bone Remodeling after Ulna Head Replacement in Distal Radioulnar Joint Arthroplasty: A Radiographic Comparison between a Partial and a Total Ulna Head Concept

2022

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Background Ulna head arthroplasty has become an eligible solution for injury or disease in the distal radioulnar joint. Bone resorption beneath the prosthetic head is often reported, but mechanism poorly understood. Purpose The aims were to evaluate bone remodeling and radiological instability in two conceptually different distal radioulnar joint arthroplasties: the total and the partial ulna head replacement. Patients and Methods We conducted a retrospective radiographic assessment of 51 ulna head arthroplasties; 26 Herbert ulna (total ulna head replacement) and 25 First Choice (partial ulna head replacement), to analyze periprosthetic bone resorption and radiologic instability. Intraoperative/immediate postoperative and 1-year radiographs were reviewed by two independent assessors. The radiographic follow-up averaged 13 (10–17) months. The size of the stem in relation to the diameter of the ulna (filling ratio) was measured on the intraoperative/immediate postoperative radiographs. Bone resorption beneath the collar of the prothesis was measured on the 1-year radiographs and expressed as a bone resorption index (BRI) between the length of the resorption and the length of the implant stem. Radiological stability was measured on both the preoperative and the 1-year lateral radiographs. Results The total ulna head prothesis presented with more extensive bone resorption beneath the prosthetic head than the partial ulna head prothesis at 1-year post surgery (p <0.001). The filling ratio did not influence the 1-year bone resorption and there was no difference regarding radiological instability between the two prosthetic designs. Conclusion The pattern of bone adaptions after an ulna head prothesis may differ due to design and concept of the prosthesis.

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Section: Discussionmentioning

confidence: 83%

Bone Remodeling after Ulna Head Replacement in Distal Radioulnar Joint Arthroplasty: A Radiographic Comparison between a Partial and a Total Ulna Head Concept

2022

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“…Of these, four were patients with rheumatoid arthritis and of these, three showed deterioration of clinical outcome, for which one was revised. 41 No implant loosening was seen intraoperatively. Apart from these three cases, none of the other studies reported a correlation of their radiologic findings with functional outcome.…”

Section: Resultsmentioning

confidence: 89%

“…At a mean follow-up of 2.5 years, seven cases of progressive osteolysis were reported (0.9%). 6 , 41 All of these were TSA cases. Of these, four were patients with rheumatoid arthritis and of these, three showed deterioration of clinical outcome, for which one was revised.…”

Section: Resultsmentioning

confidence: 99%

Results of stemless shoulder arthroplasty: a systematic review and meta-analysis

et al. 2021

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Stemless shoulder arthroplasty relies solely on cementless metaphyseal fixation and is designed to avoid stem-related problem such as intraoperative fractures, loosening, stress shielding or stress-risers for periprosthetic fractures. Many designs are currently on the market, although only six anatomic and two reverse arthroplasty designs have results published with a minimum of two-year follow-up. Compared to stemmed designs, clinical outcome is equally good using stemless designs in the short and medium-term follow-up, which is also the case for overall complication and revision rates. Intraoperative fracture rate is lower in stemless compared to stemmed designs, most likely due to the absence of intramedullary preparation and of the implantation of a stem. Radiologic abnormalities around the humeral implant are less frequent compared to stemmed implants, possibly related to the closer resemblance to native anatomy. Between stemless implants, several significant differences were found in terms of clinical outcome, complication and revision rates, although the level of evidence is low with high study heterogeneity; therefore, firm conclusions could not be drawn. There is a need for well-designed long-term randomized trials with sufficient power in order to assess the superiority of stemless over conventional arthroplasty, and of one design over another. Cite this article: EFORT Open Rev 2021;6:35-49. DOI: 10.1302/2058-5241.6.200067

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Total Shoulder Arthroplasty in the Young, Athletic Patient

Johnson,

Wharton,

McCarty

2023

Shoulder Arthritis Across the Life Span

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Reliability of stemless shoulder arthroplasty in rheumatoid arthritis: observation of early lysis around the humeral component

Cited by 4 publications

References 35 publications

Bone Remodeling after Ulna Head Replacement in Distal Radioulnar Joint Arthroplasty: A Radiographic Comparison between a Partial and a Total Ulna Head Concept

Bone Remodeling after Ulna Head Replacement in Distal Radioulnar Joint Arthroplasty: A Radiographic Comparison between a Partial and a Total Ulna Head Concept

Results of stemless shoulder arthroplasty: a systematic review and meta-analysis

Total Shoulder Arthroplasty in the Young, Athletic Patient

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