Prospective multicenter study assessing functional outcomes of shoulder arthroplasty for primary glenohumeral osteoarthritis. 176 shoulders in 160 patients treated by 19 surgeons at 17 North American sites using a single prosthetic design (Global Shoulder). Follow-up ranged from 2 to 7 years (mean 46 months).
Prior to this paper, most shoulder arthroplasty outcome data came from single-institution series mixing multiple diagnoses, making it hard to know whether results were disease-specific or surgeon-specific. This study isolated primary osteoarthritis and spread the data across 19 surgeons — proving 95% good-to-excellent outcomes are achievable broadly, not just at expert centers.
When you counsel a primary osteoarthritis patient preoperatively, these are your expected numbers: ASES score roughly doubling (34 to 84), elevation gaining 36°, external rotation gaining 31°. Either TSA or hemiarthroplasty is appropriate. If you find a reparable supraspinatus tear at surgery, repair it, but don't expect it to change the functional result.
When postoperative instability develops after shoulder arthroplasty, work up for glenoid loosening and rotator cuff tear before concluding the cause is technical. 80% of cases have an identifiable structural etiology.
Prospective multicenter study assessing functional outcomes of shoulder arthroplasty for primary glenohumeral osteoarthritis. 176 shoulders in 160 patients treated by 19 surgeons at 17 North American sites using a single prosthetic design (Global Shoulder). Follow-up ranged from 2 to 7 years (mean 46 months).
Prior to this paper, most shoulder arthroplasty outcome data came from single-institution series mixing multiple diagnoses, making it hard to know whether results were disease-specific or surgeon-specific. This study isolated primary osteoarthritis and spread the data across 19 surgeons — proving 95% good-to-excellent outcomes are achievable broadly, not just at expert centers.
When you counsel a primary osteoarthritis patient preoperatively, these are your expected numbers: ASES score roughly doubling (34 to 84), elevation gaining 36°, external rotation gaining 31°. Either TSA or hemiarthroplasty is appropriate. If you find a reparable supraspinatus tear at surgery, repair it, but don't expect it to change the functional result.
When postoperative instability develops after shoulder arthroplasty, work up for glenoid loosening and rotator cuff tear before concluding the cause is technical. 80% of cases have an identifiable structural etiology.