Anatomical total shoulder arthroplasty used for glenohumeral osteoarthritis has higher survival rates than hemiarthroplasty: a Nordic registry-based study

Rasmussen, Jeppe Vejlgaard; Hole, Randi; Metlie, Trygve; Brorson, Stig; Äärimaa, Ville; Demir, Yilmaz; Salomonsson, Björn; Jensen, Steen Lund

doi:10.1016/j.joca.2018.02.896

Cited by 44 publications

(27 citation statements)

References 38 publications

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“…The incidence of total shoulder arthroplasty (TSA) is increasing with population growth, aging, and the concomitant increase in prevalence of glenohumeral osteoarthritis (OA) [1][2][3][4]. Since the 1970s and the implantation of the first contemporary total shoulder prostheses, issues with radiolucent lines around glenoid components and aseptic loosening have been observed [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Is preoperative glenoid bone mineral density associated with aseptic glenoid implant loosening in anatomic total shoulder arthroplasty?

Mariaux

Obrist

Farron

et al. 2021

BMC Musculoskelet Disord

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Background Aseptic loosening of glenoid implants is the primary revision cause in anatomic total shoulder arthroplasty (aTSA). While supported by biomechanical studies, the impact of glenoid bone quality, more specifically bone mineral density (BMD), on aseptic glenoid loosening remains unclear. We hypothesized that lower preoperative glenoid BMD was associated with aseptic glenoid implant loosening in aTSA. Methods We retrospectively included 93 patients (69 females and 24 males; mean age, 69.2 years) who underwent preoperative non-arthrographic shoulder computed tomography (CT) scans and aTSA between 2002 and 2014. Preoperative glenoid BMD (CT numbers in Hounsfield unit) was measured in 3D using a reliable semi-automated quantitative method, in the following six contiguous volumes of interest (VOI): cortical, subchondral cortical plate (SC), subchondral trabecular, and three successive adjacent layers of trabecular bone. Univariate Cox regression was used to estimate the impact of preoperative glenoid BMD on aseptic glenoid implant loosening. We further compared 26 aseptic glenoid loosening patients with 56 matched control patients. Results Glenoid implant survival rates were 89% (95% confidence interval CI, 81–96%) and 57% (41–74%) at 5 and 10 years, respectively. Hazard ratios for the different glenoid VOIs ranged between 0.998 and 1.004 (95% CI [0.996, 1.007], p≥0.121). Only the SC VOI showed significantly lower CTn in the loosening group (622±104 HU) compared with the control group (658±88 HU) (p=0.048), though with a medium effect size (d=0.42). There were no significant differences in preoperative glenoid BMD in any other VOI between patients from the loosening and control groups. Conclusions Although the preoperative glenoid BMD was statistically significantly lower in the SC region of patients with aseptic glenoid implant loosening compared with controls, this single-VOI difference was only moderate. We are thus unable to prove that lower preoperative glenoid BMD is clearly associated with aseptic glenoid implant loosening in aTSA. However, due to its proven biomechanical role in glenoid implant survival, we recommend extending this study to larger CT datasets to further assess and better understand the impact of preoperative glenoid BMD on glenoid implant loosening/survival and aTSA outcome.

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Section: Introductionmentioning

confidence: 99%

Is preoperative glenoid bone mineral density associated with aseptic glenoid implant loosening in anatomic total shoulder arthroplasty?

Mariaux

Obrist

Farron

et al. 2021

BMC Musculoskelet Disord

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“…Their 10-year cumulative arthroplasty survival rate was 0.75. The authors concluded that the results support the use of anatomical total shoulder arthroplasty for all ages [10].…”

Section: Arthroplasty Survival Ratesmentioning

confidence: 73%

The Danish Shoulder Arthroplasty Registry

Rasmussen

Olsen

2019

Obere Extremität

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“…On the other hand, there are several publications that observed an increased risk for revision with lower age. 14 , 18 , 23 Wagner et al 23 found a clear negative correlation of age and revision risk and described for every increase in 1 year of age a 3% decreased risk of revision surgery and a 13% decreased risk of revision surgery for mechanical implant failure based on the analysis of prospectively collected data of 5494 consecutive shoulder arthroplasties performed from 1970 to 2012.…”

Section: Discussionmentioning

confidence: 99%

Analysis of revision shoulder arthroplasty in the German nationwide registry from 2014 to 2018

Kircher¹,

Ohly²,

Fal³

et al. 2021

JSES International

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Background The purpose of this study is to identify and analyze primary revision arthroplasties of the shoulder in the Germany Shoulder Arthroplasty Registry. The objective is to provide demographic and clinical data of the included cases and information about the revision surgery itself and to compare the findings to other registry studies and clinical studies. Methods All documented cases of primary revision arthroplasties of the Germany Shoulder Arthroplasty Registry in the time period 2014-2018 (n = 975) were included in the initial data analysis. Exclusion criteria were multiple revisions and data sets with a missing link of the revision arthroplasty to the data set of the primary implantation leaving n = 433 cases that were included. SPSS software (IBM SPSS Statistics for Windows, version 24.0; IBM Corp., Armonk, NY, USA) was used for statistical analyses. Results The age of patients with revised anatomic implants (66.3 years) was significantly lower than that of patients with reverse implants (77.1 years) ( P = .001). Female patients with anatomic and fracture implants were significantly older than their male counterparts (70.1 vs. 60.5 years, P = .001; 74.3 vs. 62 years, P = .019) and showed a significantly higher rate of revision than their male counterparts ( P = .001). The reason for revision was significantly different for anatomic and reverse implant systems ( P = .001). Aseptic loosening of either the humeral or glenoid component was the most common reason for revision for anatomic implants, whereas unspecified reasons, dislocation, and loosening of the glenosphere were the most common reasons for reverse implants. The most common type of revision procedure for anatomic implants was conversion to a reverse system in about one third of the cases. Most of the revisions of reverse implants were not specified and almost equally distributed for revision at the humeral or the glenoid side. Anatomic implants showed significantly better Constant-Murley scores (26.1 points) than reverse implants (19.6 points) ( P = .001) and significantly better function before revision for passive flexion ( P = .002), passive abduction ( P = .015), active external rotation ( P = .002), and passive external rotation ( P = .002). Conclusion This study provides a well-documented basis to compare revision arthroplasties of the shoulder performed in Germany over the last decade as documented in the nationwide registry with other nationwide registries and with clinical studies. Especially, the detailed analysis of intraoperative and postoperative complications and the shoulder function at the time of revision offers new information in addition to the results of ...

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Anatomical total shoulder arthroplasty used for glenohumeral osteoarthritis has higher survival rates than hemiarthroplasty: a Nordic registry-based study

Abstract: Anatomical TSA had the highest implant-survival rate. Young patients had, independently of the arthroplasty type, lower implant-survival rates. The treatment of young patients with end-stage osteoarthritis remains a challenge.

Cited by 44 publications

References 38 publications

Is preoperative glenoid bone mineral density associated with aseptic glenoid implant loosening in anatomic total shoulder arthroplasty?

Is preoperative glenoid bone mineral density associated with aseptic glenoid implant loosening in anatomic total shoulder arthroplasty?

The Danish Shoulder Arthroplasty Registry

Analysis of revision shoulder arthroplasty in the German nationwide registry from 2014 to 2018

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