Survivorship analysis of CAD-CAM total shoulder replacement.
| Autor: | Nayar SK; Shoulder and Elbow Unit, Royal National Orthopaedic Hospital, Stanmore, UK., Butt D; Shoulder and Elbow Unit, Royal National Orthopaedic Hospital, Stanmore, UK., Prinja A; Shoulder and Elbow Unit, Royal National Orthopaedic Hospital, Stanmore, UK., Rudge W; Shoulder and Elbow Unit, Royal National Orthopaedic Hospital, Stanmore, UK., Majed A; Shoulder and Elbow Unit, Royal National Orthopaedic Hospital, Stanmore, UK., Higgs D; Shoulder and Elbow Unit, Royal National Orthopaedic Hospital, Stanmore, UK., Falworth M; Shoulder and Elbow Unit, Royal National Orthopaedic Hospital, Stanmore, UK. |
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| Jazyk: | angličtina |
| Zdroj: | Shoulder & elbow [Shoulder Elbow] 2024 Jul; Vol. 16 (4), pp. 390-396. Date of Electronic Publication: 2023 Aug 07. |
| DOI: | 10.1177/17585732231193285 |
| Abstrakt: | Background: Glenoid bone loss represents a challenge in shoulder arthroplasty and often precludes standard implants. The CAD-CAM total shoulder replacement (TSR) is an option in these cases. This study aimed to assess survivorship and long-term patient outcomes of the CAD-CAM TSR. Methods: Fifty-eight patients that underwent a CAD-CAM TSR by three surgeons at a single tertiary referral centre between 2009 and 2017 were reviewed. The mean follow-up was 70 months (28-130). Data was collected on survivorship, range of movement, Oxford shoulder score (OSS, 0-48), subjective shoulder value (SSV, 0-100%), pain score (0-10), and overall patient satisfaction. Results: CAD-CAM TSR was undertaken as a primary procedure in 28% ( n = 16) for end-stage arthritis with severe glenoid bone loss, and as a revision procedure in 72% ( n = 42). Of the total, 17% ( n = 10) required component revision at a mean of 24 months (4x prosthesis loosening, 3x infection, 3x periprosthetic fracture). Forward elevation improved from 45° ± 27° to 59° ± 29° (P = 0.0056), abduction from 43° ± 29° to 55° ± 26° (P = 0.034) and external rotation from 8° ± 11° to 16° ± 14° (P = 0.031). OSS improved from 15 ± 8 to 29 ± 9 (P = 0.0009), SSV from 18 ± 16 to 62 ± 23 (P < 0.0001), and pain score from 8 ± 2 to 2 ± 2 (P < 0.0001). 88% of patients would undergo the procedure again. Conclusion: CAD-CAM TSR is reserved for complex cases involving severe glenoid bone loss, offering significant improvements in pain and function with overall positive patient satisfaction. Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. (© The Author(s) 2023.) |
| Databáze: | MEDLINE |
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