The effects of glenoid wear patterns on patients with osteoarthritis in total shoulder arthroplasty: an assessment of outcomes and value
| Autor: | Jacob L. Cox, Scott T. Marberry, Michael M. Hussey, Peter Simon, Brandon G. Santoni, Brandon M. Steen, Benjamin J. Cottrell, Michael C. Cusick, Mark A. Frankle |
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| Rok vydání: | 2014 |
| Předmět: |
musculoskeletal diseases
Adult Male Reoperation medicine.medical_specialty Glenoid Cavity Visual analogue scale Radiography medicine.medical_treatment Elbow Osteoarthritis Concentric Shoulder Pain medicine Eccentric Humans Orthopedics and Sports Medicine Arthroplasty Replacement Range of Motion Articular Aged Pain Measurement Retrospective Studies Orthodontics Aged 80 and over business.industry Shoulder Joint General Medicine Middle Aged medicine.disease Arthroplasty Surgery Prosthesis Failure medicine.anatomical_structure Treatment Outcome Female business Range of motion Tomography X-Ray Computed Follow-Up Studies |
| Zdroj: | Journal of shoulder and elbow surgery. 24(5) |
| ISSN: | 1532-6500 |
| Popis: | Background Despite the success of total shoulder arthroplasty (TSA), concerns remain about the longevity of the implant, in particular, glenoid component survivorship. The purpose of this study was to determine whether preoperative glenoid wear patterns affect clinical outcomes and value in patients undergoing TSA. Methods A comparative cohort study was conducted of 309 patients with a total of 344 TSA procedures, performed for primary glenohumeral osteoarthritis. Computed tomography scans were obtained in all patients, with preoperative glenoid wear pattern characterized as either concentric (n = 196; follow-up time, 49.2 months) or eccentric (n = 148; follow-up time, 52.3 months) according to a modified Levine classification. A clinical, radiographic, and economic assessment was performed between the 2 wear patterns. Results There was no significant difference in American Shoulder and Elbow Surgeons (ASES) score in the concentric group (80.8 ± 20.8) compared with the eccentric group (77.6 ± 21.2) at final follow-up (P = .159). Range of motion and final visual analog scale for pain score were similar between the 2 groups. Radiographic evidence of gross glenoid loosening was significantly lower in the concentric group [11 of 195 (5.6%)] compared with the eccentric group [18 of 147 (12.2%)] (P = .030). Revision rates were similar between the concentric group [4 of 195 (2.0%)] and the eccentric group [3 of 147 (2.0%)]. A value assessment also showed no significant difference between the concentric and eccentric groups [concentric 26.1 vs. eccentric 25.5 (ΔASES score/$10,000 hospital cost) (P = .479)]. Conclusions Similar clinical results and value can be expected with both concentric and eccentric glenoid wear patterns in TSA. Concerns arise, however, as the eccentric group demonstrated a more than 2-fold increased rate of glenoid component loosening compared with the concentric group. |
| Databáze: | OpenAIRE |
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