Mid- to long-term clinical and radiological results of anatomic total shoulder arthroplasty in patients with B2 glenoids
Background: Eccentric biconcave (B2) glenoid erosion in primary glenohumeral arthritis is common. There are serious concerns regarding the longevity of fixation of cemented glenoids if anatomic total shoulder arthroplasties (aTSAs) are used in B2 glenoid. The purpose of this study is to analyze the...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-05-01
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| Series: | JSES International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666638323000294 |
| _version_ | 1797837693473783808 |
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| author | Stephanie Hinse, MD Torsten Pastor, MD Anita Hasler, MD Lukas Ernstbrunner, MD, PhD Karl Wieser, MD Christian Gerber, MD, FRCS |
| author_facet | Stephanie Hinse, MD Torsten Pastor, MD Anita Hasler, MD Lukas Ernstbrunner, MD, PhD Karl Wieser, MD Christian Gerber, MD, FRCS |
| author_sort | Stephanie Hinse, MD |
| collection | DOAJ |
| description | Background: Eccentric biconcave (B2) glenoid erosion in primary glenohumeral arthritis is common. There are serious concerns regarding the longevity of fixation of cemented glenoids if anatomic total shoulder arthroplasties (aTSAs) are used in B2 glenoid. The purpose of this study is to analyze the mid- to long-term results of aTSA with B2 glenoids. Methods: This is a retrospective study of a single center experience. Thirty patients (32 shoulders) at an average of 9.2 years (range, 5.0-16.6, ±3.2) after primary TSA were evaluated. Clinical and radiographic outcomes were analyzed. Results: The mean preoperative intermediate glenoid version was −14° ± 7° (range, −2° to −29°) and the mean humeral subluxation according to the plane of the scapula was 67% ± 9% (range, 49%-87%). There was a significant improvement for all the postoperative clinical outcome parameters including the mean absolute and relative Constant Score, subjective shoulder value, active elevation, external rotation, abduction, internal rotation, pain scores, and strength (P < .001). The complication rate was 15.6% and the revision rate was 12.5% at a mean follow-up of 9.2 years (range, 5.0-16.6, ±3.2). The estimated survivorship without revision was 94% at 5 years and 85% at 10 years (12.1-14.7 years). The survival rate without advanced glenoid component loosening (defined as Lazarus grade ≥ 4 or modified Molé scores ≥ 6) was 91% at 5 years and 84% at 10 years (12.2-15.8 years). Conclusion: In this case series, aTSA with asymmetric reaming for the treatment of shoulder osteoarthritis with milder forms of B2 glenoid is a viable option with good to excellent clinical results and an 85% prosthetic survivorship at 10 years. |
| first_indexed | 2024-04-09T15:29:55Z |
| format | Article |
| id | doaj.art-385709f364924e0ca722d40e0b1b743b |
| institution | Directory Open Access Journal |
| issn | 2666-6383 |
| language | English |
| last_indexed | 2024-04-09T15:29:55Z |
| publishDate | 2023-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj.art-385709f364924e0ca722d40e0b1b743b2023-04-28T08:56:31ZengElsevierJSES International2666-63832023-05-0173464471Mid- to long-term clinical and radiological results of anatomic total shoulder arthroplasty in patients with B2 glenoidsStephanie Hinse, MD0Torsten Pastor, MD1Anita Hasler, MD2Lukas Ernstbrunner, MD, PhD3Karl Wieser, MD4Christian Gerber, MD, FRCS5Corresponding author: Stephanie Hinse, MD, Department of Orthopaedics, Balgrist University Hospital, Forchstrasse 340, 8008 Zurich, Switzerland.; Department of Orthopaedics, Balgrist University Hospital, Zurich, SwitzerlandDepartment of Orthopaedics, Balgrist University Hospital, Zurich, SwitzerlandDepartment of Orthopaedics, Balgrist University Hospital, Zurich, SwitzerlandDepartment of Orthopaedics, Balgrist University Hospital, Zurich, SwitzerlandDepartment of Orthopaedics, Balgrist University Hospital, Zurich, SwitzerlandDepartment of Orthopaedics, Balgrist University Hospital, Zurich, SwitzerlandBackground: Eccentric biconcave (B2) glenoid erosion in primary glenohumeral arthritis is common. There are serious concerns regarding the longevity of fixation of cemented glenoids if anatomic total shoulder arthroplasties (aTSAs) are used in B2 glenoid. The purpose of this study is to analyze the mid- to long-term results of aTSA with B2 glenoids. Methods: This is a retrospective study of a single center experience. Thirty patients (32 shoulders) at an average of 9.2 years (range, 5.0-16.6, ±3.2) after primary TSA were evaluated. Clinical and radiographic outcomes were analyzed. Results: The mean preoperative intermediate glenoid version was −14° ± 7° (range, −2° to −29°) and the mean humeral subluxation according to the plane of the scapula was 67% ± 9% (range, 49%-87%). There was a significant improvement for all the postoperative clinical outcome parameters including the mean absolute and relative Constant Score, subjective shoulder value, active elevation, external rotation, abduction, internal rotation, pain scores, and strength (P < .001). The complication rate was 15.6% and the revision rate was 12.5% at a mean follow-up of 9.2 years (range, 5.0-16.6, ±3.2). The estimated survivorship without revision was 94% at 5 years and 85% at 10 years (12.1-14.7 years). The survival rate without advanced glenoid component loosening (defined as Lazarus grade ≥ 4 or modified Molé scores ≥ 6) was 91% at 5 years and 84% at 10 years (12.2-15.8 years). Conclusion: In this case series, aTSA with asymmetric reaming for the treatment of shoulder osteoarthritis with milder forms of B2 glenoid is a viable option with good to excellent clinical results and an 85% prosthetic survivorship at 10 years.http://www.sciencedirect.com/science/article/pii/S2666638323000294Mid-term resultsAnatomical total shoulder arthroplastyGlenohumeral osteoarthritis B2 glenoidPosterior glenoid deficiencyHumeral subluxation |
| spellingShingle | Stephanie Hinse, MD Torsten Pastor, MD Anita Hasler, MD Lukas Ernstbrunner, MD, PhD Karl Wieser, MD Christian Gerber, MD, FRCS Mid- to long-term clinical and radiological results of anatomic total shoulder arthroplasty in patients with B2 glenoids JSES International Mid-term results Anatomical total shoulder arthroplasty Glenohumeral osteoarthritis B2 glenoid Posterior glenoid deficiency Humeral subluxation |
| title | Mid- to long-term clinical and radiological results of anatomic total shoulder arthroplasty in patients with B2 glenoids |
| title_full | Mid- to long-term clinical and radiological results of anatomic total shoulder arthroplasty in patients with B2 glenoids |
| title_fullStr | Mid- to long-term clinical and radiological results of anatomic total shoulder arthroplasty in patients with B2 glenoids |
| title_full_unstemmed | Mid- to long-term clinical and radiological results of anatomic total shoulder arthroplasty in patients with B2 glenoids |
| title_short | Mid- to long-term clinical and radiological results of anatomic total shoulder arthroplasty in patients with B2 glenoids |
| title_sort | mid to long term clinical and radiological results of anatomic total shoulder arthroplasty in patients with b2 glenoids |
| topic | Mid-term results Anatomical total shoulder arthroplasty Glenohumeral osteoarthritis B2 glenoid Posterior glenoid deficiency Humeral subluxation |
| url | http://www.sciencedirect.com/science/article/pii/S2666638323000294 |
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