Hypothesis And Background: Reimplantation of a new glenoid component for symptomatic glenoid failure after total shoulder arthroplasty (TSA) is a well-established surgical strategy. In case of aseptic glenoid loosening or failure, revision of TSA by reimplantation of a cemented glenoid implant would be a reliable therapeutic option.
Materials And Methods: This retrospective multicenter study included 42 TSAs with symptomatic failed glenoids revised by reimplantation of an all-polyethylene (PE), cemented glenoid component. All patients were reviewed clinically and radiologically, with a mean follow-up of 74 months.
Results: The failed initial glenoid component was metal backed in 32 cases and PE cemented in 10. The main cause of glenoid failure was component loosening in 19 cases (46%) and PE wear or dissociation in 23 (54%). Associated complications were very frequent, including rotator cuff tears, subscapularis insufficiency, and prosthesis instability. At last follow-up, 7 patients (17%) had already been re-revised because of symptomatic recurrent glenoid loosening. The overall rate of recurrent glenoid loosening (re-revision plus radiologic loosening) was 67%. Soft-tissue problems and prosthetic instability were significantly associated with recurrent loosening. Of the 10 associated bone grafts performed during the revision procedure, all were partially or totally lysed. At follow-up, the mean Constant score was 57 points (gain of 16 points) and the mean active anterior elevation was 125° (gain of 19°).
Conclusion: This study suggests that revision of a TSA with reimplantation of an all-PE cemented glenoid component does not solve the problem of glenoid loosening. Soft-tissue failure and prosthetic instability are underestimated preoperatively and may explain, in part, the high rate of recurrent glenoid loosening.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jse.2012.08.009 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Deltopectoral approach without subscapularis detachment for reverse shoulder arthroplasty. Technique and results of a safe and reproducible subscapularis-sparing approach.
JSES Rev Rep Tech
February 2025
Clinique Claude Bernard, Unité de Chirurgie Orthopédique, Metz, France.
Background: The importance of the subscapularis for reverse total shoulder arthroplasty has been demonstrated, especially for internal rotation and stability. In a deltopectoral approach, a detachment of the subscapularis is performed (tenotomy, tuberosity peeling, or osteotomy), but the tendon is not always repairable at the end. When it is repaired, healing is obtained in only 40%-76% of the cases, with potential consequences for the outcomes.
View Article and Find Full Text PDFCement-within-cement technique in revision reverse total shoulder arthroplasty: complications, reoperations, and revision rates at 5-year mean follow-up.
JSES Rev Rep Tech
February 2025
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
Background: Revision reverse total shoulder arthroplasty (rTSA) of a previously cemented humeral component is challenging. In hip arthroplasty, the cement-within-cement (CwC) technique has been well described as an effective option. However, for shoulder arthroplasty there remains a paucity of data investigating this technique.
View Article and Find Full Text PDFEccentric Reaming is Superior to Augmented Components in B2 Glenoids: a Biomechanical study.
J Shoulder Elbow Surg
January 2025
Division of Orthopaedic Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada. Electronic address:
Introduction: Primary glenohumeral arthritis is typically associated with glenoid retroversion and posterior bone loss. Glenoid component fixation remains a weak link in the survivorship of anatomical total shoulder arthroplasty, particularly in the B2 glenoid. The aim of this study was to compare biomechanical properties of two glenoid preparation techniques in a B2 glenoid bone loss model.
View Article and Find Full Text PDFAnatomical Total Shoulder Arthroplasty with Keeled glenoids in Patients under 60 years at 10 years minimum: which risk factors of failure are still valid at long term follow-up?
J Shoulder Elbow Surg
January 2025
Institut Universitaire Locomoteur et du Sport (IULS), Hôpital Pasteur 2, CHU de Nice, France.
Aim: To assess the long-term (>10 years) outcomes in anatomical total shoulder arthroplasty (aTSA) and implant survival in patient under 60 years and identify risk factors for complications and revision.
Methods: This was a retrospective, multicenter study conducted from 1993 to 2008. Over 104 aTSA, 87 in 82 patients (55 years, 36 to 60yo) were included at a mean follow-up of 14±4 years (10 to 25y).
Outcomes of Augmented versus Standard Baseplates in Reverse Shoulder Arthroplasty.
J Shoulder Elbow Surg
January 2025
Palm Beach Shoulder Service HCA Florida Atlantis Orthopedics, Palm Beach, FL, USA; JFK/University of Miami Department of Orthopedics, Lake Worth, FL, USA. Electronic address:
Background: Glenoid bone loss presents a complex challenge in the management of patients with glenohumeral osteoarthritis (GHOA) undergoing Reverse Shoulder Arthroplasty (RSA). Eccentric reaming and bone grafting have been utilized to address this issue but are associated with their own set of challenges. This study explores the effectiveness of augmented glenoid baseplate RSA in addressing glenoid bone loss.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!