Total Shoulder Arthroplasty Using a Bone-Sparing, Precision Multiplanar Humeral Prosthesis

Goldberg, Steven S.; Baranek, Eric S

doi:10.12788/ajo.2018.0006

Cited by 4 publications

(3 citation statements)

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“…We previously reported on this technique as being reliable in replicating the preoperative anatomy and center of rotation in both a cadaveric specimen and in clinical practice. 3,17,18 The mean patient age in this group was 73 years, which is older than the groups studied by Habermeyer, Egger, Churchill, and Berth, where the mean ages were 58, 59, 66, and 67 years, respectively. 6,13,15,20 In those studies, nonstemmed arthroplasty was shown to have very low rates of loosening over time.…”

Section: Discussionmentioning

confidence: 50%

“…This technique has been demonstrated in cadaveric and radiographic studies to be highly accurate in replicating the preoperative anatomy. 3,18 The design was inspired by the femoral component in total knee arthroplasty, which rests on dense bone just below the subchondral surface and demonstrates excellent longevity in patients over a wide age range in numerous long-term studies. 2,36,45 In order to address potential challenges encountered with a more conservative bone resection, a glenoid component with angled anchoring pegs that can be inserted from an oblique angle, in the direction of a deltopectoral incision, was developed.…”

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confidence: 99%

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Anatomic total shoulder arthroplasty using a stem-free ellipsoid humeral implant in patients of all ages

Goldberg

Baranek

Korbel

et al. 2021

Journal of Shoulder and Elbow Surgery

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Background: Stem-free shoulder arthroplasty has recently been shown to have comparable results to stemmed arthroplasty, though stemless designs are typically used in a younger patient population. Additionally, although the native humeral head is elliptical in shape, clinical results with ellipsoid implants in shoulder arthroplasty have not been reported on previously. This case series reports on the outcomes of a recently introduced anatomic total shoulder arthroplasty with an ellipsoid-shaped articular surface and unique multiplanar platform type of stemless fixation. Methods: This retrospective case series examines the initial cohort of patients who received an anatomic total shoulder arthroplasty using an ellipsoid stem-free humeral prosthesis and an all-polyethylene glenoid component from the Catalyst CSR Total Shoulder System (Catalyst OrthoScience) over a 1-year period. Inclusion criteria were patients with a diagnosis of advanced glenohumeral joint arthritis with an intact rotator cuff, regardless of patient age. Clinical outcomes including shoulder range of motion and patientreported outcome measures, as well as radiographs, were evaluated at multiple time points postoperatively, with minimum 2-year follow-up. Results: Sixty-three shoulders in 57 patients with a mean age of 73.0 years (range 60-85 years) were included in the study with a mean follow-up period of 30.5 months (range 24-41 months). Forward elevation improved from 121 to 150 (P < .0001), external rotation improved from 28 to 48 (P < .0001), and internal rotation improved from L3 to L1 (P < .001). There were statistically significant improvements exceeding the minimal clinically important difference (MCID) in the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) score (37 to 94, P <.001), Single Assessment Numeric Evaluation (SANE) (40 to 93, P <.001), visual analog scale (6.3 to 0.4, P < .001), and Patient-Reported Outcomes Measurement Information System physical domain T score (44 to 57, P < .001). The improvement in the ASES score also exceeded the threshold for the substantial clinical benefit. Age, sex, and preoperative glenoid morphology did not appear to have an effect on the clinical outcome scores. There were no implant failures or evidence of radiographic loosening of the humerus component in any patients. Conclusion: At 2-year minimum follow-up, this stem-free ellipsoid humerus total shoulder arthroplasty provides very good results with high patient satisfaction, clinical improvement in all outcome measures studied, and no signs of loosening.This study was reviewed by the Western Institutional Review Board IRB Affairs Department (IRB no. 1-1231172-1) and it was found that this research met the requirements for a waiver of consent under 45 CFR x 46.104(d)(4).

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Section: Discussionmentioning

confidence: 50%

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confidence: 99%

Anatomic total shoulder arthroplasty using a stem-free ellipsoid humeral implant in patients of all ages

Goldberg

Baranek

Korbel

et al. 2021

Journal of Shoulder and Elbow Surgery

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“…The cutting guides and surgical technique were designed to match the amount of bone resected to the thickness of the humeral head implant and were specifically developed to address the problem of inconsistency in humeral head reconstruction. 27 Minimizing the amount of bony resection during humeral head preparation has a number of benefits including improved implant fixation in the dense subchondral bone of the anatomic neck 28 and preservation of proximal bone stock in the case of revision surgery. 19 Additionally, proper positioning of the implant at the native center of the articular surface is facilitated when there is no stem affecting placement.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Humeral Implant Positioning Using a Canal-Sparing Total Shoulder Arthroplasty System

Baranek

Trofa

Levine

et al. 2019

Journal of Shoulder and Elbow Arthroplasty

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Background: Accurate restoration of anatomy is critical in reestablishing proper glenohumeral joint function in total shoulder arthroplasty (TSA). However, even experienced surgeons inconsistently achieve anatomic restoration. This study evaluates whether a new canal-sparing arthroplasty system, designed using the principles of calibrated bone resection and incorporating a nonspherical humeral head prosthesis, can assist in more accurate and reliable reproduction of proximal humeral anatomy compared to a stemmed arthroplasty system. Methods: The difference between the anatomic center of rotation (COR) of the humeral head and the postoperative prosthetic COR (defined as DCOR) was measured in a consecutive case series of 110 shoulder arthroplasties performed by a single surgeon. The first 55 cases used a stemmed arthroplasty system and the subsequent 55 cases used a new canalsparing implant system that uses a multiplanar osteotomy (MPO) during humeral head preparation. Cases with DCOR !3.0 mm were deemed clinically significant outliers. Results: The average DCOR in the MPO group was 1.7 AE 1.2 mm versus 2.8 AE 1.5 mm in the stemmed group (P ¼.00005). The incidence of outliers was lower (14.5% vs 40.0%, P ¼.005), and there were more cases with a DCOR 1.0 mm (32.7% vs 3.6%, P ¼.0001) in the MPO group compared to the stemmed group. Conclusion: The MPO TSA system provided improved accuracy and precision in restoring proximal humeral anatomy compared to stemmed arthroplasty systems, even in its initial use. This alternative method of humeral replacement may increase consistency in restoring proper anatomy and kinematics in TSA.

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Total Shoulder Arthroplasty for Glenohumeral Arthritis in a Young Patient

Mahoney¹,

Hasan

2022

Glenohumeral Osteoarthritis in the Young Patient

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Total Shoulder Arthroplasty Using a Bone-Sparing, Precision Multiplanar Humeral Prosthesis

Cited by 4 publications

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Anatomic total shoulder arthroplasty using a stem-free ellipsoid humeral implant in patients of all ages

Anatomic total shoulder arthroplasty using a stem-free ellipsoid humeral implant in patients of all ages

Accuracy of Humeral Implant Positioning Using a Canal-Sparing Total Shoulder Arthroplasty System

Total Shoulder Arthroplasty for Glenohumeral Arthritis in a Young Patient

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