The authors of Risk Factors for Rotator Cuff Tears and Aseptic Glenoid Loosening After Anatomic Total Shoulder Arthroplasty reviewed the factors associated with increased risk of cuff tears and glenoid loosening at two years after anatomic total shoulder arthroplasty in 2,699 patients from an international multicenter study who received the Equinoxe platform implants.
Postoperative cuff tears were reported in 2.5%; 1.3% had revision surgery because of a cuff tear. Patients were more likely to experience postoperative cuff tears if they had prior surgery on the affected side or were treated with a small glenoid component.
Aseptic glenoid loosening was reported in 4.0%; 3.4% had revision surgery because of glenoid loosening. Patients were more likely to experience glenoid loosening if they were ≤62 years of age at the time of surgery, treated with a small glenoid component, or treated with smooth pegged or keeled glenoid components (as opposed to hybrid glenoid components)
Patient factors:
(1) Patient age ≤62 years - this once more brings up the issue of "how do we choose the treatment of osteoarthritis in younger patients?".
(2) Prior surgery - the nature of the prior surgery is not reported. It seems likely that some of these prior surgeries may have been rotator cuff related, which could account for the observed increase in post-arthroplasty cuff tears.
Surgeon controlled factors:
(1) Small glenoid component - it is not clear whether the increased risk associated with the use of a small glenoid component is related to the size of the native glenoid, to less bony support of the component, to lesser experience of the surgeon or to other factors.
(2) Non-ingrowth pegged or keeled glenoid components - many surgeons currently prefer glenoid components that provide the opportunity for bony ingrowth instead of smooth pegs or keels.
We've still got a lot to learn.
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Here are some videos that are of shoulder interest
Shoulder arthritis - what you need to know (see this link).
How to x-ray the shoulder (see this link).
The ream and run procedure (see this link).
The total shoulder arthroplasty (see this link).
The cuff tear arthropathy arthroplasty (see this link).
The reverse total shoulder arthroplasty (see this link).
The smooth and move procedure for irreparable rotator cuff tears (see this link).
Shoulder rehabilitation exercises (see this link).
