Strauss, J Shoulder Elbow Surg 2014 - The High Failure Rate of Biologic Resurfacing of the Glenoid in Young Patients with Glenohumeral Arthritis

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The High Failure Rate of Biologic Resurfacing of the Glenoid in Young Patients with Glenohumeral Arthritis

Strauss, Romeo, et al.·J Shoulder Elbow Surg·2014·64 citations·Case series

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Background

The current study evaluated the outcomes of biologic resurfacing of the glenoid using a lateral meniscus allograft or human acellular dermal tissue matrix at intermediate-term follow-up.

Methods

45 patients (mean age, 42.2 years) underwent biologic resurfacing of the glenoid, and 41 were available for follow-up at a mean of 2.8 years.
Lateral meniscal allograft resurfacing was used in 31 patients and human acellular dermal tissue matrix interposition in 10.
Postoperative range of motion and clinical outcomes were assessed at the final follow-up.

Results

The overall clinical failure rate was 51.2%.
The lateral meniscal allograft cohort had a failure rate of 45.2%, with a mean time to failure of 3.4 years.
Human acellular dermal tissue matrix interposition had a failure rate of 70.0%, with a mean time to failure of 2.2 years.
Overall, significant improvements were seen compared with baseline with respect to the visual analog pain score (3.0 vs 6.3), American Shoulder and Elbow Surgeons score (62.0 vs 36.8), and Simple Shoulder Test score (7.0 vs 4.0).
Significant improvements were seen for forward elevation (106 to 138) and external rotation (31 to 51).

Conclusions

Despite significant improvements compared with baseline values, biologic resurfacing of the glenoid resulted in a high rate of clinical failure at intermediate follow-up. Our results suggest that biologic resurfacing of the glenoid may have a minimal and as yet undefined role in the management of glenohumeral arthritis in the young active patient over more traditional methods of hemiarthroplasty or total shoulder arthroplasty.

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

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The High Failure Rate of Biologic Resurfacing of the Glenoid in Young Patients with Glenohumeral Arthritis

Strauss, Romeo, et al.·J Shoulder Elbow Surg·2014·64 citations·Case series

|

Background

The current study evaluated the outcomes of biologic resurfacing of the glenoid using a lateral meniscus allograft or human acellular dermal tissue matrix at intermediate-term follow-up.

Methods

45 patients (mean age, 42.2 years) underwent biologic resurfacing of the glenoid, and 41 were available for follow-up at a mean of 2.8 years.
Lateral meniscal allograft resurfacing was used in 31 patients and human acellular dermal tissue matrix interposition in 10.
Postoperative range of motion and clinical outcomes were assessed at the final follow-up.

Results

The overall clinical failure rate was 51.2%.
The lateral meniscal allograft cohort had a failure rate of 45.2%, with a mean time to failure of 3.4 years.
Human acellular dermal tissue matrix interposition had a failure rate of 70.0%, with a mean time to failure of 2.2 years.
Overall, significant improvements were seen compared with baseline with respect to the visual analog pain score (3.0 vs 6.3), American Shoulder and Elbow Surgeons score (62.0 vs 36.8), and Simple Shoulder Test score (7.0 vs 4.0).
Significant improvements were seen for forward elevation (106 to 138) and external rotation (31 to 51).

Conclusions

Despite significant improvements compared with baseline values, biologic resurfacing of the glenoid resulted in a high rate of clinical failure at intermediate follow-up. Our results suggest that biologic resurfacing of the glenoid may have a minimal and as yet undefined role in the management of glenohumeral arthritis in the young active patient over more traditional methods of hemiarthroplasty or total shoulder arthroplasty.

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

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