Results of anatomic nonconstrained prosthesis in primary osteoarthritis with biconcave glenoid

Walch, Gilles; Moraga, Claudio; Young, Allan; Castellanos-Rosas, Juan

doi:10.1016/j.jse.2011.11.030

Cited by 341 publications

(241 citation statements)

References 41 publications

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“…In contrast to the findings in some prior studies [13,14,30,31,56,60], preoperative radiographic glenoid retroversion, glenoid biconcavity, and posterior decentering of the humeral head on the glenoid were not associated with worse outcomes in our patients. This may be because the surgical techniques used were effective in managing the potentially adverse effects of these pathoanatomic factors [29].…”

Section: Discussioncontrasting

confidence: 99%

“…First, the patients were those of two experienced surgeons (FAM, WJM), with similar selection criteria for the different surgical interventions and similar surgical and rehabilitation techniques; thus the outcomes reported here may not be generalizable to other practices with different combinations of patients, surgeons, diagnoses, and procedures. Second, the study design sought outcomes at a defined 2-year time; because some adverse outcomes, such as glenoid component failure may not appear until 5 or more years after the index procedure, the results with longer periods of followup might be different [47,60]. Third, while this appears to be the largest truly prospective study of its type, the sample size of 337 shoulders is still relatively small; in the future these results should be refined through the study of a larger population, ideally one drawn from multiple practice sites.…”

Section: Figmentioning

confidence: 99%

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What Factors are Predictive of Patient-reported Outcomes? A Prospective Study of 337 Shoulder Arthroplasties

Matsen

Russ

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Although shoulder arthroplasties generally are effective in improving patients' comfort and function, the results are variable for reasons that are not well understood. Questions/Purposes We posed two questions: (1) What factors are associated with better 2-year outcomes after shoulder arthroplasty? (2) What are the sensitivities, specificities, and positive and negative predictive values of a multivariate predictive model for better outcome? Methods Three hundred thirty-nine patients having a shoulder arthroplasty (hemiarthroplasty, arthroplasty for cuff tear arthropathy, ream and run arthroplasty, total shoulder or reverse total shoulder arthroplasty) between August 24, 2010 and December 31, 2012 consented to participate in this prospective study. Two patients were excluded because they were missing baseline variables. Forty-three patients were missing 2-year data. Univariate and multivariate analyses determined the relationship of baseline patient, shoulder, and surgical characteristics to a ''better'' outcome, defined as an improvement of at least 30% of the maximal possible improvement in the Simple Shoulder Test. The results were used to develop a predictive model, the accuracy of which was tested using a 10-fold cross-validation. Results After controlling for potentially relevant confounding variables, the multivariate analysis showed that the factors significantly associated with better outcomes were American Society of Anesthesiologists Class I (odds ratio [OR], 1.94; 95% CI, 1.03-3.65; p = 0.041), shoulder problem not related to work (OR, 5.36; 95% CI, 2.15-13.37; p \ 0.001), lower baseline Simple Shoulder Test score (OR, 1.32; 95% CI, 1.23-1.42; p \ 0.001), no prior shoulder surgery (OR, 1.79; 95% CI, 1.18-2.70; p = 0.006), humeral head not superiorly displaced on the AP radiograph (OR, 2.14; 95% CI, 1.15-4.02; p = Each author certifies that his or her institution approved the human protocol for this investigation that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. OR, 4.47; 95% CI,; p \ 0.001). Neither preoperative glenoid version nor posterior decentering of the humeral head on the glenoid were associated with the outcomes. The model predictive of a better result was driven mainly by the six factors listed above. The area under the receiver operating characteristic curve generated from the crossvalidated enhanced predictive model was 0.79 (generally values of 0.7 to 0.8 are considered fair and values of 0.8 to 0.9 are considered good). The false-positive fraction and the true-positive fraction depended on the cutoff probability selected (ie, the selected probability above which the prediction would be classified as a better outcome). A cutoff probability of 0.68 yielded the best performance of the model with cross-validation predictions of better outcomes for 236 patients (80%) and worse outcomes for 58 patients (20%); sensitivity of 91% (95% CI, 88%-95%); specificity of ...

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Section: Discussioncontrasting

confidence: 99%

Section: Figmentioning

confidence: 99%

What Factors are Predictive of Patient-reported Outcomes? A Prospective Study of 337 Shoulder Arthroplasties

Matsen

Russ

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…In a retrospective case review, Walch and colleagues analyzed 92 TSAs performed for a B2 glenoid at a mean follow-up of 77 months and observed a 21 % rate of glenoid loosening, which was positively correlated with posterior wear and subluxation [51]. Chin and colleagues confirmed these findings, demonstrating 48 % glenoid component radiolucencies at mean 60-months follow-up in 37 B2 glenoids that underwent TSA [52].…”

Section: Glenohumeral Osteoarthritis With An Intact Rotator Cuffmentioning

confidence: 94%

Expanding roles for reverse shoulder arthroplasty

Chalmers

Keener

2016

Curr Rev Musculoskelet Med

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Since its introduction in the USA in 2003, reverse total shoulder arthroplasty (RTSA) has been used with increasingly frequency as surgeons have observed the remarkable improvement in pain, range of motion, and function associated with this implant. RTSA was initially used exclusively for elderly, low demand individuals with end-stage rotator cuff tear arthropathy. However, RTSA is now being increasingly successfully employed for the management of irreparable rotator cuff tears, glenohumeral osteoarthritis with an intact rotator cuff, acute proximal humerus fractures, the sequelae of proximal humerus fractures, neoplasms of the proximal humerus, inflammatory arthropathy, young patients and failed anatomic total shoulder arthroplasty and hemiarthroplasty. While long-term outcomes are pending, short-and mid-term follow-up results suggest that in experienced hands, RTSA may be a reasonable treatment for many previously difficult to treat pathologies within the shoulder.

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“…These deformities do not fit into any one Walch classification category and present as the most challenging cases for standard shoulder arthroplasty. Walch et al identified neoglenoid retroversion greater than 27°in B2 glenoids as the strongest predictor of glenoid loosening and recurrent posterior humeral head subluxation in patients treated with anatomic TSA and a standard glenoid component [45]. The use of augmented components also becomes difficult in patients with excessive posterior bone loss.…”

Section: Reverse Total Shoulder Arthroplastymentioning

confidence: 99%

Surgical management of the biconcave (B2) glenoid

Donohue

Ricchetti

Iannotti

2016

Curr Rev Musculoskelet Med

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Glenohumeral osteoarthritis produces a wide spectrum of glenoid pathology. The B2 glenoid is defined by asymmetric posterior bone loss with the development of a biconcavity and posterior translation of the humeral head. Progressive bone loss results in increasing glenoid retroversion, which must be corrected during anatomic shoulder arthroplasty. The goals of arthroplasty should also include centering the humeral head and restoring the normal glenoid joint line. When there is minimal bone loss, this may be accomplished with a standard glenoid component and asymmetric reaming. More significant bone loss requires bone grafting or the use of an augmented glenoid component. Reverse shoulder arthroplasty is also an option for older patients or patients with severe bone loss.

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Results of anatomic nonconstrained prosthesis in primary osteoarthritis with biconcave glenoid

Cited by 341 publications

References 41 publications

What Factors are Predictive of Patient-reported Outcomes? A Prospective Study of 337 Shoulder Arthroplasties

What Factors are Predictive of Patient-reported Outcomes? A Prospective Study of 337 Shoulder Arthroplasties

Expanding roles for reverse shoulder arthroplasty

Surgical management of the biconcave (B2) glenoid

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