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The Bone & Joint Journal
Vol. 103-B, Issue 8 | Pages 1333 - 1338
2 Aug 2021
Kankanalu P Borton ZM Morgan ML Cresswell T Espag MP Tambe AA Clark DI

Aims

Reverse total shoulder arthroplasty (RTSA) using trabecular metal (TM)-backed glenoid implants has been introduced with the aim to increase implant survival. Only short-term reports on the outcomes of TM-RTSA have been published to date. We aim to present the seven-year survival of TM-backed glenoid implants along with minimum five-year clinical and radiological outcomes.

Methods

All consecutive elective RTSAs performed at a single centre between November 2008 and October 2014 were reviewed. Patients who had primary TM-RTSA for rotator cuff arthropathy and osteoarthritis with deficient cuff were included. A total of 190 shoulders in 168 patients (41 male, 127 female) were identified for inclusion at a mean of 7.27 years (SD 1.4) from surgery. The primary outcome was survival of the implant with all-cause revision and aseptic glenoid loosening as endpoints. Secondary outcomes were clinical, radiological, and patient-related outcomes with a five-year minimum follow-up.


The Bone & Joint Journal
Vol. 103-B, Issue 8 | Pages 1331 - 1332
1 Aug 2021
Kankanalu P Borton ZM Morgan ML Cresswell T Espag MP Tambe AA Clark DI


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_IV | Pages 504 - 505
1 Oct 2010
Kankanalu P Hockings M Veale R
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Aim: To assess and establish the reason for repeating knee arthroscopies. A retrospective study at Torbay General Hospital.

Methods and results: The sample period was from January-2004 to July 2007 during which 695 knee arthroscopies were done, of which 71 patients (10 %) were coded as having same knee scoped again. A total of 58 out of 71 patients notes were available for review of which 12 were excluded due to coding-error and septic-arthritis. Among the 45 patients included, 67% were males and mean age was 44 years (range 17 to 70 years). The average time from listing the patient to actual scope was 20 weeks (range 0 to 54). At their first scope 24 patients required partial meniscectomies, of which 11 (45%) and 6 (25%) patients had posterior-horn and body of medial meniscal tears respectively, and 7 (29%) had tears in posterior-horn of lateral meniscus. Among the 23 who had chondral defects, 73% had changes on medial femoral condyle, 70% on patella, 52% on medial tibial condyle, 47% over lateral femoral condyle, 43% on trochlear grove, and 39% on lateral tibial condyle. Thirty-three-percent patients had anterior cruciate ligament (ACL) tears and 6% require loose bodies removal.

Average time between re-scopes was 16 months (range 0 to 3.5 years). The numbers of patients requiring repeat knee arthroscopy for similar clinical problems were 16 out of 695 patients (2.3%). During repeat arthroscopies, 10/16 (62%) required procedures on meniscus, 4/16 (25%) for osteochondral lesions 2 patients had same diagnosis as ACL tears. 90% of partial meniscectomies were repeated on the posterior horn of both medial and lateral meniscus, and 20% required trimming of body of the meniscus.

Conclusion: Contrary to general opinion being too many patients knees are been re-scoped, only 16/695 patients (2.3%) had their knees re-scoped for similar problem as found at first arthroscopy. 62% of these patients required partial meniscectomy mainly on the posterior-horns and 25% had chondral defects. We concluded that MR-arthrogram should be considered due to its specificity and sensitivity as detailed in literature, before performing repeated knee arthroscopy.