Jeremy S Somerson1, Michael A Wirth2. 1. Department of Orthopaedics, University of Texas Health Science Center San Antonio, San Antonio, TX, USA. Electronic address: jeremysomerson@gmail.com. 2. Department of Orthopaedics, University of Texas Health Science Center San Antonio, San Antonio, TX, USA.
Abstract
BACKGROUND: Active and young patients who place frequent demands on their shoulder present a treatment dilemma when glenohumeral arthritis progresses to a point at which surgical intervention is considered. Humeral head replacement with nonprosthetic glenoid arthroplasty ("ream-and-run") has been proposed to address the limitations of total shoulder arthroplasty and hemiarthroplasty in this population. Several reports from a single institution have shown substantial improvement in self-assessed comfort and function after this procedure. However, to the best of our knowledge, no clinical results pertaining to this technique have been reported from other institutions. METHODS: Hemiarthroplasty with nonprosthetic glenoid arthroplasty was performed in 17 patients with a minimum 2-year follow-up. Patients were clinically evaluated preoperatively and postoperatively with physical examination, Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons score, visual analog scale, and standardized radiographs. Preoperative radiographs and patient demographics were assessed for correlation with outcome measures. RESULTS: Improvement of >30% of preoperative SST score was noted in 14 of 17 patients at a mean follow-up of 3.9 years (range, 2.0-6.8 years). SST score improved from mean 3.2 ± 3.1 preoperatively to 10.0 ± 2.6 at latest follow-up (P < .0001). American Shoulder and Elbow Surgeons score improved from mean 42 ± 23 to 90 ± 13 (P < .0001). Male patients had higher SST scores (P = .03) and greater external rotation (P = .03) at latest follow-up. CONCLUSIONS: Nonprosthetic glenoid arthroplasty demonstrated results that correlate with prior data published by the center at which the procedure was initially described. Patients with concentric glenoid morphology preoperatively did not demonstrate results superior to those of patients with eccentric glenoids.
BACKGROUND: Active and young patients who place frequent demands on their shoulder present a treatment dilemma when glenohumeral arthritis progresses to a point at which surgical intervention is considered. Humeral head replacement with nonprosthetic glenoid arthroplasty ("ream-and-run") has been proposed to address the limitations of total shoulder arthroplasty and hemiarthroplasty in this population. Several reports from a single institution have shown substantial improvement in self-assessed comfort and function after this procedure. However, to the best of our knowledge, no clinical results pertaining to this technique have been reported from other institutions. METHODS: Hemiarthroplasty with nonprosthetic glenoid arthroplasty was performed in 17 patients with a minimum 2-year follow-up. Patients were clinically evaluated preoperatively and postoperatively with physical examination, Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons score, visual analog scale, and standardized radiographs. Preoperative radiographs and patient demographics were assessed for correlation with outcome measures. RESULTS: Improvement of >30% of preoperative SST score was noted in 14 of 17 patients at a mean follow-up of 3.9 years (range, 2.0-6.8 years). SST score improved from mean 3.2 ± 3.1 preoperatively to 10.0 ± 2.6 at latest follow-up (P < .0001). American Shoulder and Elbow Surgeons score improved from mean 42 ± 23 to 90 ± 13 (P < .0001). Male patients had higher SST scores (P = .03) and greater external rotation (P = .03) at latest follow-up. CONCLUSIONS: Nonprosthetic glenoid arthroplasty demonstrated results that correlate with prior data published by the center at which the procedure was initially described. Patients with concentric glenoid morphology preoperatively did not demonstrate results superior to those of patients with eccentric glenoids.
Authors: Frederick A Matsen; Stacy M Russ; Phuong T Vu; Jason E Hsu; Robert M Lucas; Bryan A Comstock Journal: Clin Orthop Relat Res Date: 2016-07-25 Impact factor: 4.176