Total shoulder arthroplasty with nonspherical humeral head and inlay glenoid replacement: clinical results comparing concentric and nonconcentric glenoid stages in primary shoulder arthritis

Egger, Anthony C.; Peterson, Jennifer; Jones, Morgan; Miniaci, Anthony

doi:10.1016/j.jses.2019.07.009

Cited by 33 publications

(49 citation statements)

References 43 publications

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“…These range of motion improvements are clinically comparable to findings seen at 2 years of follow-up with other modern stemless and stemmed shoulder arthroplasty systems. 6,13,15,35,55 However, without a direct comparison group, we cannot comment on if the elliptical humeral head component used in this patient cohort afforded any clinical benefit compared with other prosthetic designs.…”

Section: Discussionmentioning

confidence: 94%

“…Egger et al 15 reported a series of 31 shoulders that underwent TSA using a nonspherical, ovoid-shaped humerus resurfacing implant and an inlay glenoid in a singlesurgeon series. Similar positive results were found.…”

Section: Discussionmentioning

confidence: 99%

“…33 The Lazarus scale was adapted for evaluation of the humerus to assess radiolucent lines around the pegs of the humeral component, a method previously used by other authors. 15 The humeral component was further evaluated by the method described by Habermeyer 20 and advocated by Denard 14 to evaluate for stress shielding under a stemless implant.…”

Section: Radiographic Analysismentioning

confidence: 99%

“…In type A, B1, B3, and C glenoids, version correction was not performed, and emphasis was placed on preserving cortical bone stock. 15,28 The biconcave ridge in B2 glenoids was reamed until a single concave surface was achieved, essentially converting to a B3 shape without version correction. The chosen glenoid implant was inserted using third-generation cement technique.…”

Section: Surgical Techniquementioning

confidence: 99%

“…49,62 Both traditional humerus resurfacing and more recently ''stemless'' designs have been used successfully for canal-sparing shoulder arthroplasty, though published series in the United States generally focus on a younger patient population. 13,15 Recently, a stemless design unique both for its backside geometry and its ellipsoid articular shape was developed but clinical results have yet to be reported. The implant backside has a 4-plane undersurface that rests on a platform of 4 precision osteotomies made in a similar shape to a hip roof on a house (Fig.…”

mentioning

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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