Kazuya Inoue1, Naoki Suenaga2, Naomi Oizumi2, Hiroshi Yamaguchi3, Naoki Miyoshi4, Noboru Taniguchi5, Mitsuru Munemoto6, Takuya Egawa6, Yasuhito Tanaka6. 1. Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, Japan. Electronic address: kaz_inoue12@ybb.ne.jp. 2. Upper Extremity Center of Joint Replacement and Endoscopic Surgery, Orthopaedic Hokushin Hospital, Sapporo, Hokkaido, Japan. 3. Rehabilitation Clinic Yamagichi, Naha, Okinawa, Japan. 4. Department of Orthopaedic Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan. 5. Department of Orthopaedic Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan. 6. Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, Japan.
Abstract
BACKGROUND: Bone resorption around the femoral stem after total hip arthroplasty is a well-known phenomenon. However, only a few studies have evaluated bone resorption after shoulder arthroplasty. This study investigated the prevalence of humeral bone resorption after different shoulder arthroplasty procedures. METHODS: The study included 147 shoulders that underwent total shoulder arthroplasty (TSA) or humeral head replacement (HHR) with an uncemented humeral stem from November 2008 to May 2015 and were monitored for more than 1 year. The prevalence of humeral bone resorption and risk factors were investigated. RESULTS: The most advanced grade of bone resorption, grade 0, occurred in 21 shoulders (14.3%). Grade 1 bone resorption occurred in 10 (6.8%), grade 2 in 28 (19.0%), grade 3 in 61 (41.5%), and grade 4 in 27 (18.4%). High occurrence of bone absorption was observed in zones 1, 2, and 7. Grade 4 bone resorption did not occur in zones 3 and 5. HHR, on-growth type stem coating, and occupation ratio were significant independent risk factors for grade ≥3 bone resorption, whereas female sex and HHR were significant independent risk factors for grade 4. CONCLUSION: Bone resorption was observed in 126 shoulders (85.7%), and full-thickness cortical bone resorption occurred in 27 shoulders (18.4%). Bone resorption was frequently observed at the greater tuberosity, lateral diaphysis, and calcar region (zones 1, 2, and 7). Significant risk factors included female sex, HHR with rotator cuff reconstruction, on-growth type stem coating, and high occupation ratio of the implant.
BACKGROUND: Bone resorption around the femoral stem after total hip arthroplasty is a well-known phenomenon. However, only a few studies have evaluated bone resorption after shoulder arthroplasty. This study investigated the prevalence of humeral bone resorption after different shoulder arthroplasty procedures. METHODS: The study included 147 shoulders that underwent total shoulder arthroplasty (TSA) or humeral head replacement (HHR) with an uncemented humeral stem from November 2008 to May 2015 and were monitored for more than 1 year. The prevalence of humeral bone resorption and risk factors were investigated. RESULTS: The most advanced grade of bone resorption, grade 0, occurred in 21 shoulders (14.3%). Grade 1 bone resorption occurred in 10 (6.8%), grade 2 in 28 (19.0%), grade 3 in 61 (41.5%), and grade 4 in 27 (18.4%). High occurrence of bone absorption was observed in zones 1, 2, and 7. Grade 4 bone resorption did not occur in zones 3 and 5. HHR, on-growth type stem coating, and occupation ratio were significant independent risk factors for grade ≥3 bone resorption, whereas female sex and HHR were significant independent risk factors for grade 4. CONCLUSION: Bone resorption was observed in 126 shoulders (85.7%), and full-thickness cortical bone resorption occurred in 27 shoulders (18.4%). Bone resorption was frequently observed at the greater tuberosity, lateral diaphysis, and calcar region (zones 1, 2, and 7). Significant risk factors included female sex, HHR with rotator cuff reconstruction, on-growth type stem coating, and high occupation ratio of the implant.
Authors: Jonathan Kusins; Nikolas Knowles; Melanie Columbus; Sara Oliviero; Enrico Dall'Ara; George S Athwal; Louis M Ferreira Journal: Ann Biomed Eng Date: 2020-06-22 Impact factor: 3.934
Authors: Lisa Peduzzi; Thomas Goetzmann; Frank Wein; Olivier Roche; François Sirveaux; Daniel Mole; Adrien Jacquot Journal: JSES Open Access Date: 2019-11-29