Orvets, J Shoulder Elbow Surg 2018 - Total Shoulder Arthroplasty in Patients with a B2 Glenoid Addressed with Corrective Reaming - Article Summary

Total Shoulder Arthroplasty in Patients with a B2 Glenoid Addressed with Corrective Reaming

Orvets, Keener, et al.·J Shoulder Elbow Surg·2018·71 citations·Case series

Background

This study describes the short-term functional and radiographic outcomes after total shoulder arthroplasty (TSA) in shoulders with a B2 glenoid deformity addressed with corrective reaming.

Methods

We conducted a retrospective series of consecutive patients who underwent TSA with a Walch B2 glenoid quantified by computed tomography scan.
All glenoid deformities were addressed using partially corrective glenoid reaming.
Radiographic and functional outcome measures, including scores on the visual analog scale for pain, American Shoulder and Elbow Standardized Shoulder Assessment, and Simple Shoulder Test were collected.

Results

Functional outcome scores were available for 59 of 92 eligible subjects (64%) at a mean of 50 months.
The mean preoperative retroversion measured 18° (range, –1° to 36°), superior inclination was 8° (range, –11° to 27°), and posterior subluxation was 67% (range, 39%-91%).
Mean visual analog scale improved from 7.4 to 1.4, the American Shoulder and Elbow Shoulder Standardized Assessment improved from 35.4 to 84.3, and the SST improved from 4.5 to 9.1.
Radiographs were evaluated at a mean of 31 months: 38 had no glenoid radiolucent lines, 13 glenoids had grade 1, 2 had grade 2, and 5 had grade 3 lucencies.
There was no difference in the rate of progression of glenoid radiolucencies between shoulders with a preoperative glenoid version of ≤20° (27.8%) compared with glenoids with >20° of retroversion (22.7%, P = .670).
No shoulders were revised due to glenoid loosening or instability.

Conclusions

TSA with partial corrective glenoid reaming in selected shoulders with a B2 glenoid deformity resulted in excellent functional and radiographic outcomes at short-term follow-up, with a low risk of revision surgery.

Level of evidence: Level IV; Case Series; Treatment Study. Copyright remains with the authors and publisher.

Supplemental

Total Shoulder Arthroplasty in Patients with a B2 Glenoid Addressed with Corrective Reaming.

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Total Shoulder Arthroplasty in Patients with a B2 Glenoid Addressed with Corrective Reaming

Orvets, Keener, et al.·J Shoulder Elbow Surg·2018·71 citations·Case series

DOI·PubMed

Background

This study describes the short-term functional and radiographic outcomes after total shoulder arthroplasty (TSA) in shoulders with a B2 glenoid deformity addressed with corrective reaming.

Methods

We conducted a retrospective series of consecutive patients who underwent TSA with a Walch B2 glenoid quantified by computed tomography scan.
All glenoid deformities were addressed using partially corrective glenoid reaming.
Radiographic and functional outcome measures, including scores on the visual analog scale for pain, American Shoulder and Elbow Standardized Shoulder Assessment, and Simple Shoulder Test were collected.

Results

Functional outcome scores were available for 59 of 92 eligible subjects (64%) at a mean of 50 months.
The mean preoperative retroversion measured 18° (range, –1° to 36°), superior inclination was 8° (range, –11° to 27°), and posterior subluxation was 67% (range, 39%-91%).
Mean visual analog scale improved from 7.4 to 1.4, the American Shoulder and Elbow Shoulder Standardized Assessment improved from 35.4 to 84.3, and the SST improved from 4.5 to 9.1.
Radiographs were evaluated at a mean of 31 months: 38 had no glenoid radiolucent lines, 13 glenoids had grade 1, 2 had grade 2, and 5 had grade 3 lucencies.
There was no difference in the rate of progression of glenoid radiolucencies between shoulders with a preoperative glenoid version of ≤20° (27.8%) compared with glenoids with >20° of retroversion (22.7%, P = .670).
No shoulders were revised due to glenoid loosening or instability.

Conclusions

Level of evidence: Level IV; Case Series; Treatment Study. Copyright remains with the authors and publisher.

Background

This study describes the short-term functional and radiographic outcomes after total shoulder arthroplasty (TSA) in shoulders with a B2 glenoid deformity addressed with corrective reaming.

Methods

We conducted a retrospective series of consecutive patients who underwent TSA with a Walch B2 glenoid quantified by computed tomography scan.
All glenoid deformities were addressed using partially corrective glenoid reaming.
Radiographic and functional outcome measures, including scores on the visual analog scale for pain, American Shoulder and Elbow Standardized Shoulder Assessment, and Simple Shoulder Test were collected.

Results

Functional outcome scores were available for 59 of 92 eligible subjects (64%) at a mean of 50 months.
The mean preoperative retroversion measured 18° (range, –1° to 36°), superior inclination was 8° (range, –11° to 27°), and posterior subluxation was 67% (range, 39%-91%).
Mean visual analog scale improved from 7.4 to 1.4, the American Shoulder and Elbow Shoulder Standardized Assessment improved from 35.4 to 84.3, and the SST improved from 4.5 to 9.1.
Radiographs were evaluated at a mean of 31 months: 38 had no glenoid radiolucent lines, 13 glenoids had grade 1, 2 had grade 2, and 5 had grade 3 lucencies.
There was no difference in the rate of progression of glenoid radiolucencies between shoulders with a preoperative glenoid version of ≤20° (27.8%) compared with glenoids with >20° of retroversion (22.7%, P = .670).
No shoulders were revised due to glenoid loosening or instability.

Conclusions

Level of evidence: Level IV; Case Series; Treatment Study. Copyright remains with the authors and publisher.

Background

This study describes the short-term functional and radiographic outcomes after total shoulder arthroplasty (TSA) in shoulders with a B2 glenoid deformity addressed with corrective reaming.

Methods

We conducted a retrospective series of consecutive patients who underwent TSA with a Walch B2 glenoid quantified by computed tomography scan.
All glenoid deformities were addressed using partially corrective glenoid reaming.
Radiographic and functional outcome measures, including scores on the visual analog scale for pain, American Shoulder and Elbow Standardized Shoulder Assessment, and Simple Shoulder Test were collected.

Results

Functional outcome scores were available for 59 of 92 eligible subjects (64%) at a mean of 50 months.
The mean preoperative retroversion measured 18° (range, –1° to 36°), superior inclination was 8° (range, –11° to 27°), and posterior subluxation was 67% (range, 39%-91%).
Mean visual analog scale improved from 7.4 to 1.4, the American Shoulder and Elbow Shoulder Standardized Assessment improved from 35.4 to 84.3, and the SST improved from 4.5 to 9.1.
Radiographs were evaluated at a mean of 31 months: 38 had no glenoid radiolucent lines, 13 glenoids had grade 1, 2 had grade 2, and 5 had grade 3 lucencies.
There was no difference in the rate of progression of glenoid radiolucencies between shoulders with a preoperative glenoid version of ≤20° (27.8%) compared with glenoids with >20° of retroversion (22.7%, P = .670).
No shoulders were revised due to glenoid loosening or instability.

Conclusions

Level of evidence: Level IV; Case Series; Treatment Study. Copyright remains with the authors and publisher.