The relationship of shoulder elevation strength to patient-reported outcome after anatomic total shoulder arthroplasty.

Background: Most patient-reported outcome measures (PROMs) used to assess outcomes after anatomic total shoulder arthroplasty (aTSA) focus on pain and function. Although strength is considered an important component of function, only the Constant-Murley score (CMS) includes an objective measurement of shoulder strength. The purpose of this study was to evaluate the relationship between shoulder elevation strength (SES) and PROMs after aTSA for the treatment of primary glenohumeral osteoarthritis (GHOA).

One and two-year clinical outcomes for a polyethylene glenoid with a fluted peg: one thousand two hundred seventy individual patients from eleven centers.

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.

Glenoid Bone Loss in Reverse Shoulder Arthroplasty Treated with Bone Graft Techniques.

The reverse shoulder arthroplasty facilitates surgical treatment of primary and revision shoulder with rotator cuff and bone deficiencies. Wear pattern classifications and a logical treatment approach for glenoid bone loss enable the surgeon to address a difficult series of problems in the reconstructions where the glenoid might not otherwise be able to support the implants. Bone grafting using the native humeral head in primary cases, and in revision cases, iliac crest are the most reliable sources for structural grafts for the worn or deficient glenoid vault.

Radiographic changes and clinical outcomes associated with an adjustable diaphyseal press-fit humeral stem in primary reverse shoulder arthroplasty.

Background: Press-fit humeral fixation in reverse shoulder arthroplasty (RSA) has become increasingly popular; however, radiographic analysis of these stems is limited. We aimed to evaluate the radiographic and clinical outcomes of an adjustable diaphyseal press-fit humeral stem in primary RSA.

Methods: We conducted a retrospective review of 232 primary RSAs in 219 patients performed by a single surgeon using this system.

Radiographic evaluation of short-stem press-fit total shoulder arthroplasty: short-term follow-up.

Background: Humeral loosening is an uncommon etiology for revision shoulder arthroplasty. We aimed to evaluate the radiographic and clinical outcomes of a short-stem press-fit humeral component after primary total shoulder arthroplasty.

Methods: We reviewed our patient database, from January 2008 to December 2011, for primary total shoulder arthroplasties performed with a short-stem press-fit humeral component.

Analysis of severely fractured glenoid components: clinical consequences of biomechanics, design, and materials selection on implant performance.

Background: The longevity of total shoulder replacement is primarily limited by the performance of the ultrahigh-molecular-weight polyethylene (UHMWPE) glenoid component in vivo. Variations in glenoid design (conformity, thickness), biomechanics (joint kinematics), and UHMWPE material selection (sterilization, cross-linking) distinguish total shoulder replacements from hip and knee arthroplasty devices. These variables can lead to severe mechanical failures, including gross fracture.

Radiographic and clinical outcomes of total shoulder arthroplasty with an all-polyethylene pegged bone ingrowth glenoid component: prospective short- to medium-term follow-up.

Background: Glenoid components often cause total shoulder arthroplasty failure. This study examines short-term to midterm radiographic and clinical results of a hybrid glenoid component with 3 cemented peripheral pegs and a central peg, which allows biologic fixation with use of native humeral head autograft.

Methods: In 4 years, 80 glenoid components were implanted during primary total shoulder arthroplasty with at least 2-year follow-up data.

Clinical results of revision shoulder arthroplasty using the reverse prosthesis.

Background: Success of revision shoulder arthroplasty using an unconstrained prosthesis depends on an intact rotator cuff and satisfactory bone quantity. However, the reverse shoulder arthroplasty can stabilize a glenohumeral joint even in patients with rotator cuff deficiency and bone deficits, resulting in improved outcomes.

Materials And Methods: Thirty shoulders in 28 patients with a failed arthroplasty were investigated consecutively between 2005 and 2008.

Optimizing glenosphere position and fixation in reverse shoulder arthroplasty, Part One: The twelve-mm rule.

The Aequalis Reversed Shoulder Prosthesis (Tornier, Inc., Edina, MN) is a successful treatment option for older, low-demand patients with rotator cuff arthropathy. Scapular notching is the most common radiographic complication and is associated with poorer intermediate-term clinical outcomes.

Optimizing glenosphere position and fixation in reverse shoulder arthroplasty, Part Two: The three-column concept.

Scapular geometry is complex, and a screw-placement technique for optimizing glenoid component fixation with an Aequalis Reversed Shoulder Prosthesis (Tornier, Inc., Edina, MN) has not yet been described. Ten cadaveric human scapulae were implanted with 2 types of reverse arthroplasty baseplates, 1 with fixed-angle locking screw holes and 1 with multidirectional locking screw holes.

Treatment of glenoid loosening and bone loss due to osteolysis with glenoid bone grafting.

Twenty-four patients underwent conversion of a total shoulder replacement to a humeral head replacement with glenoid bone grafting for glenoid loosening due to osteolysis. Of the 24 patients, 18 (75%) had satisfactory pain relief at a mean follow-up of 33.4 months (range, 24-63 months).

Indications for prosthetic replacement in proximal humeral fractures.

Prosthetic replacement is a good treatment option in osteoporotic patients with four-part fractures, fracture-dislocations, head-split fractures with more than 40% articular surface involvement, anatomic neck fractures, dislocations present for longer than 6 months, and selected three-part fractures. Early prosthetic replacement of proximal humeral fractures has a better outcome than late reconstructive prosthetic management. Prosthetic design features specific forfracture care have led to a reduction in complications.

Influence of preoperative factors on outcome of shoulder arthroplasty for glenohumeral osteoarthritis.

Background: The results of shoulder arthroplasty for osteoarthritis have been reported to be excellent or good for the majority of patients, but the value of using a glenoid component and the anatomic factors that affect outcome are still debated. The purpose of this study was to evaluate the influence of an operatively confirmed full-thickness tear of the rotator cuff, the severity of preoperative erosion of glenoid bone, preoperative radiographic evidence of subluxation of the humeral head, and the severity of preoperative loss of the passive range of motion on the outcome of total shoulder arthroplasty and hemiarthroplasty.

Methods: In a multicenter clinical outcome study, we evaluated 128 shoulders in 118 patients with primary osteoarthritis who had been followed for a mean of forty-six months (range, twenty-four to eighty-seven months).

Decision making in glenohumeral arthroplasty.

Prosthetic replacement arthroplasty for glenohumeral arthritis is a well-developed and well-described technique with good and excellent results. The surgeon is faced with many decisions to make, however, regarding choice of implant, implant fixation, soft tissue management, and options for glenoid resurfacing. In general, when the precise cause of the arthritic condition is identified, the choices become more straightforward.

Functional outcome after shoulder arthroplasty for primary osteoarthritis: a multicenter study.

Shoulder arthroplasty outcomes have been reported in many case series. Typically, these series have followed either a single prosthesis used to treat a variety of arthritic disorders of the shoulder or experience in a single institution. In contrast, this report of a prospective study summarizes the experience of several surgeons with a single prosthetic design for treatment of primary osteoarthritis of the shoulder.

Retrieved glenoid components: a classification system for surface damage analysis.

There have been many reports describing modes of damage in retrieved total hip and total knee arthroplasty components. The most common mechanism in total hip arthroplasties has been shown to be surface wear. Fatigue failure shown as pitting and delamination are observed more often in total knee components.