Frederick A Matsen1, Joseph P Iannotti2, R Sean Churchill3, Lieven De Wilde4, T Bradley Edwards5, Matthew C Evans6, Edward V Fehringer7, Gordon I Groh8, James D Kelly9, Christopher M Kilian10, Giovanni Merolla11, Tom R Norris9, Giuseppe Porcellini12, Edwin E Spencer13, Anne Vidil14, Michael A Wirth15, Stacy M Russ16, Moni Neradilek17, Jeremy S Somerson18. 1. Department of Orthopaedics and Sports Medicine, University of Washington Medical Center, 1959 NE Pacific Street, Box 356500, Seattle, WA, 98195-6500, USA. matsen@uw.edu. 2. Department of Orthopaedic Surgery, Cleveland Clinic, Mail Code A41, G Building, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. 3. Orthopaedic Surgery, Aurora Health Center, 3003 W Good Hope Road, Milwaukee, WI, 53209, USA. 4. Shoulder & Elbow Surgery, Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium. 5. Fondren Orthopaedic Group, L.L.P., 7401 S Main St, Houston, TX, 77030, USA. 6. Upper Limb Unit, Melbourne Orthopaedic Group, 33 The Avenue, Windsor, Melbourne, VIC, 3181, Australia. 7. Orthopaedic Shoulder and Elbow Surgery, Columbus Community Hospital Orthopaedics and Sports Medicine, 4508 38th Street, Suite 133, Columbus, NE, 68601, USA. 8. Asheville Orthopaedic Associates, P.A, 111 Victoria Road, Asheville, NC, 28801, USA. 9. California Pacific Orthopaedics, 2351 Clay Street, Suite 510, San Francisco, CA, 94115, USA. 10. Orthopaedic Associates of Wisconsin, N15 W28300 Golf Road, Pewaukee, WI, 53072, USA. 11. Shoulder and Elbow Unit, "D. Cervesi" Hospital, Via L. v. Beethoven 46, 47841, Cattolica, Italy. 12. Orthopaedic and Trauma Unit, University of Modena and Reggio Emilia, Via Universita, 4, 41121, Modena, MO, Italy. 13. Knoxville Orthopaedic Clinic, 260 Fort Sanders West Blvd, Knoxville, TN, 37922, USA. 14. Paris Shoulder Unit, Clinique Bizet, 21 rue Georges Bizet, 75116, Paris, France. 15. Department of Orthopaedics, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7774, San Antonio, TX, 78229-3900, USA. 16. Department of Orthopaedics & Sports Medicine, University of Washington, 4245 Roosevelt Way NE, Box 354740, Seattle, WA, 98105, USA. 17. The Mountain-Whisper-Light Statistics, 1827 23rd Avenue East, Seattle, WA, 98112, USA. 18. The University of Texas Medical Branch, 301 University Blvd., Route 0165, Galveston, TX, 77555-0165, USA.
Abstract
PURPOSE: Clinical shoulder science lacks a benchmark against which the early clinical value of new glenoid components can be compared; such a benchmark may be derived from a multicenter study of patients receiving an established, internationally used design of glenoid component. METHODS: We obtained data from 11 centers on 1270 patients having total shoulder arthroplasty using an all-polyethylene component with a fluted central peg. We analyzed individual patient outcomes at 1 and 2 years after surgery. We compared the improvement for each patient to the minimal clinically important difference (MCID) and calculated each patient's improvement as a percent of maximal possible improvement (MPI). RESULTS: The preoperative scores improved from SST 3 ± 2, ASES 37 ± 15, Constant score 36 ± 16, and Penn score 30 ± 19 to SST 10 ± 2, ASES 90 ± 12, Constant 76 ± 13, and Penn 80 ± 24 (p < 0.001 for each). A high percentage of patients improved by more than the MCID (SST 96%, ASES 98%, Constant 94%, Penn 93%) and obtained improvement of at least 30% of the MPI (SST 95%, ASES 98%, Constant 91%, Penn 87%). The clinical outcomes realized with this glenoid design were not worse for the 41% of shoulders with preoperative type B glenoids or for the 30% of shoulders with more than 15 degrees of glenoid retroversion. CONCLUSIONS: Individual patients from 11 international practices having total shoulder arthroplasty using a basic glenoid component design obtained highly significant clinical outcomes, providing a benchmark against which the early outcomes of new designs can be compared to determine whether they provide increased clinical value.
PURPOSE: Clinical shoulder science lacks a benchmark against which the early clinical value of new glenoid components can be compared; such a benchmark may be derived from a multicenter study of patients receiving an established, internationally used design of glenoid component. METHODS: We obtained data from 11 centers on 1270 patients having total shoulder arthroplasty using an all-polyethylene component with a fluted central peg. We analyzed individual patient outcomes at 1 and 2 years after surgery. We compared the improvement for each patient to the minimal clinically important difference (MCID) and calculated each patient's improvement as a percent of maximal possible improvement (MPI). RESULTS: The preoperative scores improved from SST 3 ± 2, ASES 37 ± 15, Constant score 36 ± 16, and Penn score 30 ± 19 to SST 10 ± 2, ASES 90 ± 12, Constant 76 ± 13, and Penn 80 ± 24 (p < 0.001 for each). A high percentage of patients improved by more than the MCID (SST 96%, ASES 98%, Constant 94%, Penn 93%) and obtained improvement of at least 30% of the MPI (SST 95%, ASES 98%, Constant 91%, Penn 87%). The clinical outcomes realized with this glenoid design were not worse for the 41% of shoulders with preoperative type B glenoids or for the 30% of shoulders with more than 15 degrees of glenoid retroversion. CONCLUSIONS: Individual patients from 11 international practices having total shoulder arthroplasty using a basic glenoid component design obtained highly significant clinical outcomes, providing a benchmark against which the early outcomes of new designs can be compared to determine whether they provide increased clinical value.
Entities:
Keywords:
All-polyethylene; Clinical outcomes; Glenoid; Ingrowth; Minimal clinically important difference; Peg; Percentage of maximal possible improvement
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