The authors point out that reverse shoulder arthroplasty is quickly becoming the most frequently performed glenohumeral joint replacement, being used to treat cases that previously would have been successfully managed with a conventional anatomic total shoulder.
In 15 patients with at least an average of 8 years after surgery, they evaluated the volumetric and linear wear rates of ultrahigh-molecular-weight polyethylene humeral liners in vivo using radiostereometric analysis to image 15 patients at terminal range of motion in forward flexion, abduction, external rotation, and internal rotation and with the arm at the side. The relative position and orientation of the glenosphere and polyethylenewere identified for each arm position.
The apparent intersection of the glenosphere into the polyethylene was recorded as wear.
The mean volumetric and linear wear rates for the 13 shoulders with 36-mm liners were 42 mm^3/yr and 0.11 mm/yr, respectively. The graph below shows the progression with time.
The mean volumetric and linear wear rates for the two shoulders with 42-mm liners were substantially greater than for the smaller liner: 114 mm^3/yr and 0.17 mm/yr, respectively.
Comment: The polyethylene wear particles resulting from this wear can stimulate an inflammatory response (see this link). These results may help explain the reported deterioration in reverse total shoulder clinical outcomes with time.
See this related article
Long-term results of the Delta Xtend reverse shoulder prosthesis
These authors reviewed 126 primary Delta Xtend reverse total shoulder prostheses implanted in our center by an individual surgeon from October 2006 until December 2009. Of these, 38 patients died, 12 were lost to follow-up, and 2 needed early revision of the prosthesis.
These authors reviewed 126 primary Delta Xtend reverse total shoulder prostheses implanted in our center by an individual surgeon from October 2006 until December 2009. Of these, 38 patients died, 12 were lost to follow-up, and 2 needed early revision of the prosthesis.
Follow-up of at least 8 years was available for 74 patients. The mean follow-up in our population was 113.1 months.
The mean adjusted Constant Score was 44.6% preoperatively. It increased significantly to 75.8% after surgery and to 91.1% at 5 years. At the latest follow-up, the mean aCS had declined to 79.9%.
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