Radiolucency in stemless shoulder arthroplasty is associated with an imaging phenomenon

Hudek, Robert; Werner, Birgit; Abdelkawi, Ayman F.; Schmitt, Rainer; Gohlke, Frank

doi:10.1002/jor.23478

Cited by 17 publications

(3 citation statements)

References 41 publications

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“…In this context, it should be mentioned that radiographic changes around humeral components are to be interpreted with caution. Hudek et al showed that, depending on the radiation scatter, radiolucency in stemless shoulder arthroplasty is associated with an imaging phenomenon with a high rate of misinterpretation [12].…”

Section: » Reduced Stem Lengths Closely Mimic the Intact Shoulder Statementioning

confidence: 99%

Short-stem anatomical shoulder replacement—a systematic review

Schnetzke

Loew²,

Raiss³

et al. 2019

Obere Extremität

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Section: » Reduced Stem Lengths Closely Mimic the Intact Shoulder Statementioning

confidence: 99%

Short-stem anatomical shoulder replacement—a systematic review

Schnetzke

Loew²,

Raiss³

et al. 2019

Obere Extremität

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“…After switching to an impaction method there might be a learning curve for the surgeon which can lead to difference in result. Furthermore, the method of examining radiolucent lines commonly used as indication for loosening seems to have limitations of its own [21,22].…”

Section: Discussionmentioning

confidence: 99%

Screw fixation in stemless shoulder arthroplasty for the treatment of primary osteoarthritis leads to less osteolysis when compared to impaction fixation

Alikhah

Imiolczyk

Krukenberg

et al. 2020

BMC Musculoskelet Disord

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Background Stemless total shoulder arthroplasty is a well-established and reliable surgical treatment option for glenohumeral osteoarthritis resulting in loss of pain and improvement of shoulder function. Currently the two methods for the fixation of the humeral component are either screw fixation or impaction. The purpose of this study is the clinical and radiological comparison of two different stemless designs (screw fixation vs impaction) for total shoulder arthroplasties in patients suffering from primary glenohumeral osteoarthritis. Methods A retrospective cohort study including 39 patients with a mean age of 67 years and a minimum follow-up of 2 years was performed. Patients were separated into two groups based on the selected implant. In group A (n = 18) a screw fixation design and in group B (n = 21) an impaction type design was used. For clinical examination the Constant-Murley-Score (CS) and Subjective-Shoulder-Value (SSV) were evaluated. Radiological examination was performed on true-AP, axial and Y-view radiographs. Results In group A the CS increased from 27.1 to 65.2 points and SSV from 27.3 to 76.7% (p < 0.05). No osteolysis of the medial calcar or subsidence of the humeral implant were found in this group. In group B the CS increased from 29.0 to 72.6 points and SSV from 33.1 to 85% (p < 0.05). Osteolysis of the medial calcar was present in seven patients in this group. No signs for humeral loosening were found in both groups. Conclusion Impaction and screw fixation total shoulder arthroplasty for primary glenohumeral osteoarthritis using a stemless device provide reliable clinical results. The screw fixation seems to prevent osteolysis of the medial calcar.

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“…The clinical significance of stress shielding under a stemless implant is unknown and could possibly be explained by a radiographic phenomenon rather than actual bone loss. 14,20,24,40 We did not include evaluation of axillary radiographs in this study as the majority were performed at one of several outside community radiology clinics and inconsistency in arm positioning did not allow for reliable grading with this method. This also limited our ability to evaluate ''recentering'' the glenohumeral joint.…”

Section: Discussionmentioning

confidence: 99%

Anatomic total shoulder arthroplasty using a stem-free ellipsoid humeral implant in patients of all ages

Goldberg

Baranek

Korbel

et al. 2021

Journal of Shoulder and Elbow Surgery

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Background: Stem-free shoulder arthroplasty has recently been shown to have comparable results to stemmed arthroplasty, though stemless designs are typically used in a younger patient population. Additionally, although the native humeral head is elliptical in shape, clinical results with ellipsoid implants in shoulder arthroplasty have not been reported on previously. This case series reports on the outcomes of a recently introduced anatomic total shoulder arthroplasty with an ellipsoid-shaped articular surface and unique multiplanar platform type of stemless fixation. Methods: This retrospective case series examines the initial cohort of patients who received an anatomic total shoulder arthroplasty using an ellipsoid stem-free humeral prosthesis and an all-polyethylene glenoid component from the Catalyst CSR Total Shoulder System (Catalyst OrthoScience) over a 1-year period. Inclusion criteria were patients with a diagnosis of advanced glenohumeral joint arthritis with an intact rotator cuff, regardless of patient age. Clinical outcomes including shoulder range of motion and patientreported outcome measures, as well as radiographs, were evaluated at multiple time points postoperatively, with minimum 2-year follow-up. Results: Sixty-three shoulders in 57 patients with a mean age of 73.0 years (range 60-85 years) were included in the study with a mean follow-up period of 30.5 months (range 24-41 months). Forward elevation improved from 121 to 150 (P < .0001), external rotation improved from 28 to 48 (P < .0001), and internal rotation improved from L3 to L1 (P < .001). There were statistically significant improvements exceeding the minimal clinically important difference (MCID) in the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) score (37 to 94, P <.001), Single Assessment Numeric Evaluation (SANE) (40 to 93, P <.001), visual analog scale (6.3 to 0.4, P < .001), and Patient-Reported Outcomes Measurement Information System physical domain T score (44 to 57, P < .001). The improvement in the ASES score also exceeded the threshold for the substantial clinical benefit. Age, sex, and preoperative glenoid morphology did not appear to have an effect on the clinical outcome scores. There were no implant failures or evidence of radiographic loosening of the humerus component in any patients. Conclusion: At 2-year minimum follow-up, this stem-free ellipsoid humerus total shoulder arthroplasty provides very good results with high patient satisfaction, clinical improvement in all outcome measures studied, and no signs of loosening.This study was reviewed by the Western Institutional Review Board IRB Affairs Department (IRB no. 1-1231172-1) and it was found that this research met the requirements for a waiver of consent under 45 CFR x 46.104(d)(4).

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Radiolucency in stemless shoulder arthroplasty is associated with an imaging phenomenon

Cited by 17 publications

References 41 publications

Short-stem anatomical shoulder replacement—a systematic review

Short-stem anatomical shoulder replacement—a systematic review

Screw fixation in stemless shoulder arthroplasty for the treatment of primary osteoarthritis leads to less osteolysis when compared to impaction fixation

Anatomic total shoulder arthroplasty using a stem-free ellipsoid humeral implant in patients of all ages

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