Retrospective cohort reporting long-term outcomes of 113 Neer total shoulder arthroplasties performed between 1975 and 1981. Mean follow-up was 12.2 years (range 5-17 years). The study addresses implant survival, pain relief, functional recovery, and radiographic loosening patterns for this foundational early-generation prosthesis.
At a time when short-term shoulder arthroplasty studies reported glenoid lucency rates of 45-93% but largely dismissed clinical significance, this study — with nearly a decade of radiographic follow-up. Proved that glenoid loosening progresses and causes pain.
When you see a patient with increasing shoulder pain years after total shoulder arthroplasty, glenoid loosening is the diagnosis to rule out first. Radiographic loosening (complete lucent line 1.5 mm or shift in position) carried a highly significant association with pain in this series (p = 0.0001).
For preoperative counseling: rotator cuff status at surgery is the variable that most determines how much motion a patient will recover. A patient with a major cuff tear at index arthroplasty should expect elevation averaging only 68°. Set realistic expectations before the operation, not after.
This paper is the historical foundation for two enduring principles in shoulder arthroplasty: cemented glenoid fixation is preferred (polyethylene, all-cemented in this series), and humeral stem cementation outperforms press-fit for this stem design. Modern implant evolution. Pegged glenoids, ingrowth humeral stems, and ultimately reverse arthroplasty for cuff-deficient shoulders. Was shaped directly by the failure patterns documented here.
Retrospective cohort reporting long-term outcomes of 113 Neer total shoulder arthroplasties performed between 1975 and 1981. Mean follow-up was 12.2 years (range 5-17 years). The study addresses implant survival, pain relief, functional recovery, and radiographic loosening patterns for this foundational early-generation prosthesis.
At a time when short-term shoulder arthroplasty studies reported glenoid lucency rates of 45-93% but largely dismissed clinical significance, this study — with nearly a decade of radiographic follow-up. Proved that glenoid loosening progresses and causes pain.
When you see a patient with increasing shoulder pain years after total shoulder arthroplasty, glenoid loosening is the diagnosis to rule out first. Radiographic loosening (complete lucent line 1.5 mm or shift in position) carried a highly significant association with pain in this series (p = 0.0001).
For preoperative counseling: rotator cuff status at surgery is the variable that most determines how much motion a patient will recover. A patient with a major cuff tear at index arthroplasty should expect elevation averaging only 68°. Set realistic expectations before the operation, not after.
This paper is the historical foundation for two enduring principles in shoulder arthroplasty: cemented glenoid fixation is preferred (polyethylene, all-cemented in this series), and humeral stem cementation outperforms press-fit for this stem design. Modern implant evolution. Pegged glenoids, ingrowth humeral stems, and ultimately reverse arthroplasty for cuff-deficient shoulders. Was shaped directly by the failure patterns documented here.