Background: Hypoplastic glenoid morphology in the setting of glenohumeral osteoarthritis is a rare yet complex surgical problem. Treatment of this patient population with anatomic total shoulder arthroplasty (aTSA) remains controversial. Furthermore, there is no gold-standard approach, with limited guidance for surgeons on the need for glenoid version correction in the setting of a dysplastic glenoid. The purpose of this study was to evaluate mid- to long-term outcomes and reoperation rates of aTSA for the treatment of primary glenohumeral osteoarthritis with Walch type C glenoid deformity.
Methods: This observational, retrospective cohort study identified patients with a Walch type C glenoid who underwent aTSA at 2 institutions between 2007 and 2016. Patients were contacted to complete updated patient-reported outcome measures at a minimum of 5.5 years postoperatively. The outcome measures collected included the American Shoulder and Elbow Surgeons (ASES) score and Single Assessment Numeric Evaluation (SANE) score. Secondary outcomes included any additional surgical procedures on the operative shoulder, patient satisfaction, and willingness to undergo aTSA again.
Results: In total, 30 patients met the inclusion criteria, of whom 26 (86.7%) were able to be contacted to undergo final outcome evaluations. The mean age at the time of surgery was 61.3 years (range, 40.9-75.5 years), and 20 patients (76.9%) were men. The mean follow-up period was 8.5 years (range, 5.5-11.3 years) after surgery. Treatment was performed with an augmented component in 9 patients and with a standard component in 17. Of the 17 patients with non-augmented components, 9 underwent partial correction with asymmetrical reaming, 3 received a mini-inset glenoid component, and 2 had an anteriorly offset humeral component. At final follow-up, patients had a mean ASES score of 83.6 ± 16.7, ASES pain score of 24.7 ± 20.8, SANE score of 80.4 ± 20.9, and patient satisfaction rate of 84.1%. No statistically significant differences in any outcome measure were observed between patients with augmented glenoid components and those with non-augmented glenoid components. One revision to reverse shoulder arthroplasty was performed for instability at 7 years postoperatively after a traumatic dislocation. All patients reported that they would be willing to undergo the same surgical procedure again.
Discussion: Despite variance in glenoid reconstructive approach, aTSA provides satisfactory and sustained improvements in patient-reported outcomes in patients with glenoid dysplasia and primary glenohumeral osteoarthritis with a low revision rate at a mean of 8.5 years. Anatomic shoulder arthroplasty should remain a surgical option in patients with Walch type C glenoid deformity.
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http://dx.doi.org/10.1016/j.jse.2023.02.007 | DOI Listing |
J Clin Orthop Trauma
February 2025
University of Tennessee Health Science Center ¬ Campbell Clinic Department of Orthopaedic Surgery and Biomedical Engineering, 1400 S. Germantown Pkwy, Germantown, TN, 38138, USA.
Introduction: Reverse shoulder arthroplasty (RSA) and anatomic total shoulder arthroplasty (TSA) are well-known methods of treating glenohumeral arthritis, which often leads to posterior wear of the glenoid. This study compared minimum two-year outcome measures in patients treated with RSA and TSA for Walch B2 and B3 glenoids.
Methods: Thirty-eight shoulders underwent TSA and 40 shoulders underwent RSA by two fellowship-trained shoulder surgeons at a tertiary referral center.
J Orthop
July 2025
Department of Orthopaedic Surgery, Virginia Commonwealth University, 1250 E. Marshall Street, Richmond, VA, 23219, USA.
Background: The use of large multi-institutional databases in rotator cuff repair (RCR) research is expanding, but these studies are observational and cannot establish causation. This study examines the prevalence of causal language in clinical RCR database studies published from 2013 to 2022.
Methods: Administrative database and clinical registry studies on RCR published in eight orthopaedic journals from 2013 to 2022 were systematically identified and graded by two reviewers for the presence, absence, or inconsistent use of causal language in both the title/abstract and the full text.
BMC Musculoskelet Disord
January 2025
Department of Clinical Sciences, College of Veterinary Medicine, Columbus, OH, USA.
Background: Rotator cuff repairs may fail because of compromised blood supply, suture anchor pullout, or poor fixation to bone. To augment the repairs and promote healing of the tears, orthobiologics, such a platelet-rich plasma (PRP), and biologic scaffolds have been applied with mixed results. Adipose allograft matrix (AAM), which recruits native cells to damaged tissues, may also be a potential treatment for rotator cuff tears.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
January 2025
Department of Orthopedic Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, SUNY, Buffalo, NY, USA.
Background: The purpose of this study was to assess the incidence of glenoid and humeral component malposition in failed primary shoulder arthroplasty requiring revision. We hypothesized that glenoid and humeral component malposition would be a prevalent feature in cases requiring revision arthroplasty for primary anatomic TSA, primary RSA, and primary hemiarthroplasty procedures.
Methods: A retrospective cross-sectional study was performed focusing on identifying the incidence of malpositioned components in shoulder arthroplasty in quantitative and qualitative reviews.
JBJS Rev
January 2025
Department of Orthopaedic Surgery, University of California Davis, Sacramento, California.
» Patients with diabetes mellitus (DM) undergoing shoulder arthroplasty (SA) have a unique risk profile, which must be considered by clinicians.» The presence of DM as a comorbidity is associated with longer length of stay following SA, greater likelihood of nonhome discharge, and a higher rate of 90-day readmission.» Though the incidence is low, patients with DM are at an increased risk of serious postoperative cardiovascular complications, such as pulmonary embolism, venous thromboembolism, and myocardial infarction.
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