Friday, February 22, 2013

Keeled glenoid for total shoulder in young adults

Mid- to long-term follow-up of total shoulder arthroplasty using a keeled glenoid in young adults with primary glenohumeral arthritis

This is a multicenter Level IV report of  52 total shoulders using a keeled glenoid to treat primary glenohumeral arthritis in patients aged 55 years or younger. Minimum follow-up of 5 years was available in 50 patients at a mean of 115.5 months postoperatively.
Survivorship of the glenoid component with revision surgery for glenoid loosening as the endpoint was 98%  at 5 years and 62.5% at 10 years. This is very interesting in that it indicates the annualized revision rate was 0.4% per year at year five and 3.8% per year at 10 years. This accelerating annualized loosening rate is especially important considering the mean patient age of 50.5 at the time of surgery.

Complications requiring revision surgery were observed in 17 patients - over one third. Glenoid loosening was the most frequent complication that required revision and was observed in 12 cases. Other complications included 2 subscapularis ruptures, 1 case of humeral component loosening, 1 oversized humeral head component, and 1 case of postoperative stiffness. A total of 21 revision surgeries were performed in these 17 patients. 
For these reasons we continue to explore the role of the ream and run procedure in the management of glenohumeral arthritis in young / active patients.


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