Pyrocarbon interposition shoulder arthroplasty in young arthritic patients: a prospective observational study
| Autor: | Olivier A. van der Meijden, Laurie Tran, Pascal Boileau, Tristan Langlais, Hugo Barret, Marc-Olivier Gauci |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Fractures Stress Glenoid Cavity Shoulders medicine.medical_treatment Arthritis 03 medical and health sciences 0302 clinical medicine Postoperative Complications Risk Factors Osteoarthritis medicine Humans Orthopedics and Sports Medicine Prospective Studies Range of Motion Articular Survival rate Aged 030222 orthopedics Stress fractures business.industry Shoulder Joint Shoulder Dislocation Shoulder Prosthesis 030229 sport sciences General Medicine Humerus Middle Aged medicine.disease Arthroplasty Carbon Surgery Radiography Arthroplasty Replacement Shoulder Shoulder Fractures Observational study Female business Greater Tuberosity Follow-Up Studies |
| Zdroj: | Journal of shoulder and elbow surgery. 29(1) |
| ISSN: | 1532-6500 |
| Popis: | We evaluated survival and midterm results of pyrocarbon interposition shoulder arthroplasty (PISA) in arthritic patients younger than 65 years.Fifty-eight PISAs (InSpyre; Tornier-Wright, Bloomington, MN, USA), implanted in 56 patients between 2010 and 2015, were prospectively observed. The mean age at surgery was 52 ± 13 years. The cause was primary osteoarthritis (18), fracture sequelae (16), post-instability arthritis (15), aseptic necrosis (3), inflammatory disease (2), and failed hemiarthroplasty (4); 34 shoulders (61%) had previously undergone surgery. Glenoid erosion was assessed in 4 grades according to the Sperling classification. Humeral erosion was also assessed in 4 grades. Multivariate analysis was used to determine predisposing risk factors for both humeral and glenoid erosion.At a mean follow-up of 47 ± 15 months, survival rate was 90%. Six patients (10%) required conversion to reverse total shoulder prosthesis for painful glenoid erosion (n = 2) and humeral erosion with greater tuberosity stress fractures (n = 4). The mean Constant score and subjective shoulder value significantly increased from 36 ± 14 points to 70 ± 15 points and 32% ± 14% to 75% ± 19%, respectively (P.001). Humeral medialization was observed in 78% of the cases with increased pain score. Uncorrected anteroposterior implant subluxation (12 cases) was associated with lower Constant score (50 points vs. 72 points; P = .02) and lower subjective shoulder value (53% vs. 78%; P = .002). On multivariate analysis, no risk factors for glenoid or humeral erosion were found.At midterm follow-up, PISA does not protect from progressive glenoid erosion and can lead to greater tuberosity erosion and stress fractures. Longer follow-up is required to see whether PISA survival will be superior to that of hemiarthroplasty. |
| Databáze: | OpenAIRE |
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