Surface replacement arthroplasty for glenohumeral arthropathy in patients aged younger than fifty years: results after a minimum ten-year follow-up

Levy, Ofer; Tsvieli, Oren; Merchant, Julia; Young, L W; Trimarchi, Alberto; Dattani, Rupen; Abraham, Ruben; Copeland, Stephen A.; Narvani, A; Atoun, Ehud

doi:10.1016/j.jse.2014.11.035

Cited by 84 publications

(49 citation statements)

References 25 publications

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“…Those results support rather than contradict our findings, as the study did not measure the BMD under the implant surface but at the periprosthetic rim and stem of the implant where the stress shielding pattern lead to an increase of the bone substance. This might also explain why periprosthetic osteolysis is only observed in few implants on standard radiographs …”

Section: Discussionmentioning

confidence: 99%

Resurfacing of the humeral head: An analysis of the bone stock and osseous integration under the implant

Schmidutz

Sprecher

Milz

et al. 2015

Journal Orthopaedic Research

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Cementless-surface-replacement-arthroplasty (CSRA) of the shoulder aims for functional joint restoration with minimal bone loss. Good clinical results have been reported, but due to the radiopaque metal shell no data is available on the structure, osseous integration, and bone stock under the implant. 14 hemi-CSRAs (4 manufacturers) with two geometries (crown [n ¼ 7]/ stem [n ¼ 7] fixation) were retrieved from patients undergoing revision due to glenoidal erosion. Histological sections cutting through the implant centre and bone were analysed. Quantitative histomorphometry evaluated the bone-implant-contact and compared the bone-area to native humeral retrievals (n ¼ 7). The boneimplant-interface was further assessed by scanning-electron-microscopy (SEM) and energy-dispersive-x-ray (EDX). Qualitative histology revealed a reduced and inhomogeneous bone stock. Obvious signs of stress shielding were observed with bone predominantly visible at the stem and implant rim. Quantitative histomorphometry confirmed the significantly reduced bone-area (9.2 AE 3.9% [crown 9.9 AE 4.3%, stem 8.6 AE 3.6%]) compared to native humeri (21.2 AE 9.1%; p < 0.05). Bone-implant-contact was 20.5 AE 5.8% (crown 21.8 AE 6.2%, stem 19.2 AE 5.6%) which was confirmed by SEM and EDX. Altogether, CRSA shows satisfactory bone ingrowth at the interface suggesting sufficient primary stability to allow osseous integration. However, clear signs of stress shielding with an inhomogeneous and reduced bone stock were observed. The impact on the long-termresults is unclear requiring further investigation. ß

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Section: Discussionmentioning

confidence: 99%

Resurfacing of the humeral head: An analysis of the bone stock and osseous integration under the implant

Schmidutz

Sprecher

Milz

et al. 2015

Journal Orthopaedic Research

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“…Especially in the young patient with long life-time expectancy other arthroplasty types such as resurfacing hemiarthroplasty (RHA) has been used in order to avoid replacement of the glenoid. Theoretically, revision to a TSA is facilitated by the bone preserving design 12,13 , and some surgeons may see the RHA as the first in a series of arthroplasties. RHA is; however, associated with a high risk of revision mainly because of glenoid wear 14 and previous literature has, despite the bone preserving design, reported disappointing outcomes of the revision procedure 15,16 .…”

Section: Introductionmentioning

confidence: 99%

Anatomical total shoulder arthroplasty used for glenohumeral osteoarthritis has higher survival rates than hemiarthroplasty: a Nordic registry-based study

Rasmussen

Hole

Metlie

et al. 2018

Osteoarthritis and Cartilage

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“…Levy and Copeland [12,13] introduced the notion of shoulder resurfacing. The short-and mid-term outcomes are good, though it remains challenging to reproduce normal anatomy, with risks of implant oversizing or varus misalignment.…”

Section: Discussionmentioning

confidence: 99%

Is the humeral stem useful in anatomic total shoulder arthroplasty?

Matsukawa

Boileau

Brunner

et al. 2017

International Orthopaedics (SICOT)

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Purpose Traditionally and since Neer, the humeral side of shoulder arthroplasty consisted of a stemmed component but the real need for stem fixation in total shoulder arthroplasty (TSA) has barely been investigated. The current study evaluated the clinical and radiological outcomes with a stemless TSA. Methods Forty-seven patients, 20 female and 27 male patients with an average age of 63, were selected in four orthopaedic centres during a four year period, and implanted with a humeral head prosthesis with a three-fin design and titanium coating. Aetiologies were: primary osteoarthritis (29), fracture sequelae (12) and avascular osteonecrosis (6). Minimum follow-up was two years (range 24-51 months). The patients were evaluated with the Constant score (CS) and radiological exams. Results Two patients had revision of the implants, one for persistent pain and one for secondary massive rotator cuff tear. At the final follow-up, the mean CS was 69, with an average gain of 36. All parameters improved with a foremost in pain relief. Mean satisfaction rate was 87%. Average anterior active elevation was 131°with a gain of 48. Radiologic evaluations showed stable implants in all cases. However, 17 cases demonstrated radiolucent areas, particularly superior and lateral to the implant, which neither decreased nor increased with time. No revisions were related to humeral component loosening. Conclusions Stemless TSA provides the same results as compared to TSA with a humeral stem. We are still unsure as to the nature of the lucent zones and we are continuing our investigation to better understand this radiological phenomenon.

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Surface replacement arthroplasty for glenohumeral arthropathy in patients aged younger than fifty years: results after a minimum ten-year follow-up

Cited by 84 publications

References 25 publications

Resurfacing of the humeral head: An analysis of the bone stock and osseous integration under the implant

Resurfacing of the humeral head: An analysis of the bone stock and osseous integration under the implant

Anatomical total shoulder arthroplasty used for glenohumeral osteoarthritis has higher survival rates than hemiarthroplasty: a Nordic registry-based study

Is the humeral stem useful in anatomic total shoulder arthroplasty?

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