Anatomic total shoulder arthroplasty with an inlay glenoid component: clinical outcomes and return to activity

Cvetanovich, Gregory L.; Naylor, Amanda J.; O’Brien, Morrough P.; Waterman, Brian R.; Garcia, Grant H.; Nicholson, Gregory P.

doi:10.1016/j.jse.2019.10.003

Cited by 38 publications

(40 citation statements)

References 32 publications

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“…The study found no significant differences between Walch Type A and Type B glenoids 29 for the Penn Shoulder Score, ROM, and VAS-Pain. Cvetanovich et al 4 found significantly improved clinical outcomes and no reoperations or radiographic loosening in an active population at 40.4 months of follow-up with a high rate of return to heavy occupational demand levels and sporting activities. The average ROM across all three studies exceeded 150° of FE and 50° of ER (current study: FE = 155° and ER = 51°).…”

Section: Discussionmentioning

confidence: 98%

“…Previous reports on iTSA showed significant improvement in ROM and function outcomes but did not interpret outcomes in response to these benchmarks. 4 , 6 …”

Section: Discussionmentioning

confidence: 99%

“…Results from partial humeral inlay arthroplasty have been reported in the past. 25 , 26 However, to the best of our knowledge, evidence on the combination of nonspherical humeral head (HH) and inlay glenoid replacement is limited to two recent studies which found significant improvement in patient-reported outcome (PRO) and range of motion (ROM), a high rate of return to work and sport, 4 and similar results for both concentric and nonconcentric shoulders. 6 …”

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confidence: 99%

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Inlay total shoulder arthroplasty for primary glenohumeral arthritis

Uribe¹,

Zvijac²,

Porter³

et al. 2021

JSES International

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Background Anatomic total shoulder arthroplasty with a nonspherical humeral head and inlay glenoid replacement has been introduced in the past; however, clinical evidence remains limited. We hypothesized that patients with advanced glenohumeral arthritis demonstrate significant improvements in pain and function. Methods Prospective patient-reported outcomes (PROs) included the American Shoulder and Elbow Surgeons score, a pain visual analog scale, and satisfaction. Range of motion was compared to the preoperative status. A sensitivity analysis examined responder rates and compared them to literature thresholds using the minimal clinically important difference and substantial clinical benefit. The preoperative glenoid morphology was determined using the Walsh classification. Zone-specific periprosthetic radiolucent lines were quantified at the last follow-up. Results Thirty-nine shoulders in 36 patients (3 bilateral) with a mean age of 65.9 years (26 males, 13 females) and a mean follow-up of 41.0 months were included. Ninety-three percent had grade III osteoarthritis, and 7% grade II. The glenoid Walsh classification included A1 (25%), A2 (25%), B1 (22%), B2 (25%), and C (3%). All PROs improved significantly ( P < .001) with a mean American Shoulder and Elbow Surgeons score from 30.4 to 77.1, a pain visual analog scale from 8.1 to 1.5, and excellent (9.1/10) patient satisfaction. PRO-related responder rates for minimal clinically important difference and substantial clinical benefit were ≥85%. Forward elevation improved from 107° to 155°, and external rotation from 22° to 51°. One intraoperative glenoid rim fracture led to advanced radiolucency; no other clinically relevant lucency was observed. Conclusion Treatment with inlay total shoulder arthroplasty demonstrated significant functional improvement, excellent pain relief, and patient satisfaction in patients with advanced shoulder arthritis and various glenoid morphology types. Our initial results provide further support for this new option in primary shoulder replacement.

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Section: Discussionmentioning

confidence: 98%

“…Previous reports on iTSA showed significant improvement in ROM and function outcomes but did not interpret outcomes in response to these benchmarks. 4 , 6 …”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Inlay total shoulder arthroplasty for primary glenohumeral arthritis

Uribe¹,

Zvijac²,

Porter³

et al. 2021

JSES International

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“…In a cadaveric study by Gagliono et al, onlay glenoid components exhibited gross loosening during fatigue testing, whereas the inlay glenoid components did not, and the onlay glenoids experienced significantly higher forces acting on them than did the native or inlay glenoids [ 52 ]. Short term results are promising, with good improvement in PROs, function, and ROM, without increased complication rates, and low reoperation rates [ 53 ]. This has been true even in the setting of posterior glenoid erosion, with no differences in short term clinical and radiographic outcomes evaluating non-spherical humeral head and inlay glenoid components in concentric (Walch A) glenoids compared to non-concentric (Walch B1 and B2) glenoids, according to the work of Egger et al [ 54 ].…”

Section: New Perspectives and Innovations In Anatomic Shoulder Arthro...mentioning

confidence: 99%

“…Inlay components may be of particular benefit in the younger, athletic, weight-lifting population given the theoretical decrease in mechanical loosening and resultant lack of restrictions afforded to them. Early clinical results have been excellent, and most of these patients are able to return to sports and lifting at the same or higher level [ 53 , 55 ].…”

Section: New Perspectives and Innovations In Anatomic Shoulder Arthro...mentioning

confidence: 99%

Innovations in Shoulder Arthroplasty

Leafblad

Asghar

Tashjian

2022

JCM

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Innovations currently available with anatomic total shoulder arthroplasty include shorter stem designs and augmented/inset/inlay glenoid components. Regarding reverse shoulder arthroplasty (RSA), metal augmentation, including custom augments, on both the glenoid and humeral side have expanded indications in cases of bone loss. In the setting of revision arthroplasty, humeral options include convertible stems and newer tools to improve humeral implant removal. New strategies for treatment and surgical techniques have been developed for recalcitrant shoulder instability, acromial fractures, and infections after RSA. Finally, computer planning, navigation, PSI, and augmented reality are imaging options now available that have redefined preoperative planning and indications as well intraoperative component placement. This review covers many of the innovations in the realm of shoulder arthroplasty.

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