Inlay total shoulder arthroplasty for primary glenohumeral arthritis

© 2021 The Authors.

Bibliographische Detailangaben
Veröffentlicht in:JSES international. - 2020. - 5(2021), 6 vom: 17. Nov., Seite 1014-1020
1. Verfasser: Uribe, John W (VerfasserIn)
Weitere Verfasser: Zvijac, John E, Porter, David A, Saxena, Anshul, Vargas, Luis A
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2021
Zugriff auf das übergeordnete Werk:JSES international
Schlagworte:Journal Article Anatomic total shoulder arthroplasty glenohumeral arthritis inlay glenoid minimal clinically important difference non-spherical humeral head substantial clinical benefit
Beschreibung
Zusammenfassung:© 2021 The Authors.
BACKGROUND: Anatomic total shoulder arthroplasty with a nonspherical humeral head and inlay glenoid replacement has been introduced in the past; however, clinical evidence remains limited. We hypothesized that patients with advanced glenohumeral arthritis demonstrate significant improvements in pain and function
METHODS: Prospective patient-reported outcomes (PROs) included the American Shoulder and Elbow Surgeons score, a pain visual analog scale, and satisfaction. Range of motion was compared to the preoperative status. A sensitivity analysis examined responder rates and compared them to literature thresholds using the minimal clinically important difference and substantial clinical benefit. The preoperative glenoid morphology was determined using the Walsh classification. Zone-specific periprosthetic radiolucent lines were quantified at the last follow-up
RESULTS: Thirty-nine shoulders in 36 patients (3 bilateral) with a mean age of 65.9 years (26 males, 13 females) and a mean follow-up of 41.0 months were included. Ninety-three percent had grade III osteoarthritis, and 7% grade II. The glenoid Walsh classification included A1 (25%), A2 (25%), B1 (22%), B2 (25%), and C (3%). All PROs improved significantly (P < .001) with a mean American Shoulder and Elbow Surgeons score from 30.4 to 77.1, a pain visual analog scale from 8.1 to 1.5, and excellent (9.1/10) patient satisfaction. PRO-related responder rates for minimal clinically important difference and substantial clinical benefit were ≥85%. Forward elevation improved from 107° to 155°, and external rotation from 22° to 51°. One intraoperative glenoid rim fracture led to advanced radiolucency; no other clinically relevant lucency was observed
CONCLUSION: Treatment with inlay total shoulder arthroplasty demonstrated significant functional improvement, excellent pain relief, and patient satisfaction in patients with advanced shoulder arthritis and various glenoid morphology types. Our initial results provide further support for this new option in primary shoulder replacement
Beschreibung:Date Revised 28.04.2022
published: Electronic-eCollection
Citation Status PubMed-not-MEDLINE
ISSN:2666-6383
DOI:10.1016/j.jseint.2021.07.014