Aims. Optimal glenoid positioning in reverse shoulder arthroplasty (RSA) is crucial to provide impingement-free range of motion (ROM). Lateralization and inclination correction are not yet systematically used. Using planning software, we simulated the most used
Metal and ceramic humeral head bearing surfaces are available choices in anatomical shoulder arthroplasties. Wear studies have shown superior performance of ceramic heads, however comparison of clinical outcomes according to bearing surface in total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) is limited. This study aimed to compare the rates of revision and reoperation following metal and ceramic humeral head TSA and HA using data from the National Joint Registry (NJR), which collects data from England, Wales, Northern Ireland, Isle of Man and the States of Guernsey. NJR shoulder arthroplasty records were linked to Hospital Episode Statistics and the National Mortality Register. TSA and HA performed for osteoarthritis (OA) in patients with an intact rotator cuff were included. Metal and ceramic humeral head prostheses were matched within separate TSA and HA groups using propensity scores based on 12 and 11 characteristics, respectively. The primary outcome was time to first revision and the secondary outcome was non-revision reoperation.Aims
Methods
Patients receiving reverse total shoulder arthroplasty (RTSA) often have osseous erosions because of glenohumeral arthritis, leading to increased surgical complexity.
To report early (two-year) postoperative findings from a randomized controlled trial (RCT) investigating disease-specific quality of life (QOL), clinical, patient-reported, and radiological outcomes in patients undergoing a total shoulder arthroplasty (TSA) with a second-generation uncemented trabecular metal (TM) glenoid versus a cemented polyethylene glenoid (POLY) component. Five fellowship-trained surgeons from three centres participated. Patients aged between 18 and 79 years with a primary diagnosis of glenohumeral osteoarthritis were screened for eligibility. Patients were randomized intraoperatively to either a TM or POLY glenoid component. Study intervals were: baseline, six weeks, six-, 12-, and 24 months postoperatively. The primary outcome was the Western Ontario Osteoarthritis Shoulder QOL score. Radiological images were reviewed for metal debris. Mixed effects repeated measures analysis of variance for within and between group comparisons were performed.Aims
Methods
Aims. Reverse total shoulder arthroplasty (RTSA) using trabecular metal (TM)-backed
The aim of this study was to describe a quantitative 3D CT method to measure rotator cuff muscle volume, atrophy, and balance in healthy controls and in three pathological shoulder cohorts. In all, 102 CT scans were included in the analysis: 46 healthy, 21 cuff tear arthropathy (CTA), 18 irreparable rotator cuff tear (IRCT), and 17 primary osteoarthritis (OA). The four rotator cuff muscles were manually segmented and their volume, including intramuscular fat, was calculated. The normalized volume (NV) of each muscle was calculated by dividing muscle volume to the patient’s scapular bone volume. Muscle volume and percentage of muscle atrophy were compared between muscles and between cohorts.Aims
Methods
The Mathys Affinis Short is the most frequently used stemless total shoulder prosthesis in the UK. The purpose of this prospective cohort study is to report the survivorship, clinical, and radiological outcomes of the first independent series of the Affinis Short prosthesis. From January 2011 to January 2019, a total of 141 Affinis Short prostheses were implanted in 127 patients by a single surgeon. Mean age at time of surgery was 68 (44 to 89). Minimum one year and maximum eight year follow-up (mean 3.7 years) was analyzed using the Oxford Shoulder Score (OSS) at latest follow-up. Kaplan-Meier survivorship analysis was performed with implant revision as the endpoint. Most recently performed radiographs were reviewed for component radiolucent lines (RLLs) and proximal humeral migration.Aims
Methods
Glenoid failure remains the most common mode of total shoulder arthroplasty failures. Porous tantalum metal (Trabecular Metal™, Zimmer) have grown in popularity in hip and knee arthroplasty. First-generation porous tantalum metal-backed glenoid components demonstrated metal debris, resulted in failure, and were revised to second-generation
INTRODUCTION. 3D preoperative planning software for anatomic and reverse total shoulder arthroplasty (ATSA and RTSA) provides additional insight for surgeons regarding implant selection and placement. Interestingly, the advent of such software has brought previously unconsidered questions to light on the optimal way to plan a case. In this study, a survey of shoulder specialists from the American Shoulder and Elbow Society (ASES) was conducted to examine thought patterns in current
INTRODUCTION. The advent of CT based 3D preoperative planning software for reverse total shoulder arthroplasty (RTSA) provides surgeons with more data than ever before to prepare for a case. Interestingly, as the usage of such software has increased, further questions have appeared over the optimal way to plan and place a
INTRODUCTION. 3D preoperative planning software for anatomic total shoulder arthroplasty (ATSA) provides surgeons with increased ability to visualize complex joint relationships and deformities. Interestingly, the advent of such software has seemed to create less of a consensus on the optimal way to plan an ATSA rather than more. In this study, a survey of shoulder specialists from the American Shoulder and Elbow Society (ASES) was conducted to examine thought patterns in current ATSA implant selection and placement. METHODS. 172 ASES members completed an 18-question survey on their thought process for how they select and place an ATSA
Accurate measurement of the glenoid version is important in performing total shoulder arthroplasty (TSA). Our aim was to evaluate the Ellipse method, which involves formally defining the vertical mid-point of the glenoid prior to measuring the glenoid version and comparing it with the ‘classic’ Friedman method. This was a retrospective study which evaluated 100 CT scans for patients who underwent a primary TSA. The glenoid version was measured using the Friedman and Ellipse methods by two senior observers. Statistical analyses were performed using the paired Aims
Methods
Introduction. The degree of glenoid bone loss associated with primary glenohumeral osteoarthritis can influence the type of
Severe glenoid bone loss in patients with osteoarthritis with intact rotator cuff is associated with posterior glenoid bone loss and posterior humeral subluxation. Management of severe glenoid bone loss during shoulder arthroplasty is controversial and technically challenging and options range from humeral hemiarthroplasty, anatomic shoulder replacement with glenoid bone grafting or augmented
In an effort to address the relatively high rate of glenoid component lucent lines, loosening and failure, tantalum/trabecular metal
INTRODUCTION. Variability in placement of total shoulder arthroplasty (TSA)
INTRODUCTION. Preoperative planning software for anatomic total shoulder arthroplasty (ATSA) allows surgeons to virtually perform a reconstruction based off 3D models generated from CT scans of the glenohumeral joint. The purpose of this study was to examine the distribution of chosen
Background. Medical advances and an ageing population mean that more people than ever rely on artificial joints. In the past years, shoulder joint replacement has developed rapidly and the numbers of shoulder prostheses implanted increased dramatically. Wear is one of the main contributors to the failure of shoulder implants. It is therefore important to measure the wear properties of the articulating surfaces within the joint in vitro. Investigation of wear characteristics through a comprehensive range of motion using a sophisticated shoulder simulator would reveal the durability of the material, the performance of component design and the safety analyses of prostheses. The purpose of the work was to develop and validate a multi-station shoulder simulator, which could accurately simulate physiological gleno-humeral forces and displacements during activities of daily living. Materials and Methods. Imperial shoulder simulator was designed with six articulating stations and one loaded soak control station for anatomical shoulder system wear simulation. It gives an adduction-abduction (AA) range of-15° to 55°, flexion-extension (FE) range of −90° to 90° and internal external rotation (IER) range of 15° to −90°. The rotations are applied simultaneously to the humeral implants by using stepper motors with integral position encoders. Axial and shear loadings to each
INTRODUCTION. Preoperative planning software for reverse total shoulder arthroplasty (RTSA) allows surgeons to virtually perform a reconstruction based off 3D models generated from CT scans of the glenohumeral joint. While anatomical studies have defined the range of normal values for glenoid version and inclination, there is no clear consensus on glenoid component selection and position for RTSA. The purpose of this study was to examine the distribution of chosen