Reduction of scapulohumeral subluxation with posterior augmented glenoid implants in anatomic total shoulder arthroplasty: Short-term 3D comparison between pre- and post-operative CT.

Details

Serval ID
serval:BIB_52518463E3B9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Reduction of scapulohumeral subluxation with posterior augmented glenoid implants in anatomic total shoulder arthroplasty: Short-term 3D comparison between pre- and post-operative CT.
Journal
Orthopaedics & traumatology, surgery & research
Author(s)
Terrier A., Goetti P., Becce F., Farron A.
ISSN
1877-0568 (Electronic)
ISSN-L
1877-0568
Publication state
Published
Issued date
06/2020
Peer-reviewed
Oui
Volume
106
Number
4
Pages
681-686
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Failure rates in anatomic total shoulder arthroplasty (aTSA) are higher in case of asymmetric glenoid bone loss secondary to posterior wear, and in persistent static posterior subluxation of the humeral head (PSH).
This study aimed to test the hypothesis that the combined use of posterior augmented glenoid (PAG) implants with three-dimensional (3D) surgical planning and patient-specific instrumentation (PSI) guides helps reduce short-term PSH after aTSA in patients with type B2-B3 glenoids.
We included nine consecutive patients with primary glenohumeral osteoarthritis and type B2 or B3 glenoids, who underwent aTSA with cemented keeled PAG implants (posterior augments of 15, 25, or 35 degrees). All patients underwent preoperative shoulder computed tomography (CT) scans, with 3D surgical planning coupled to PSI at the time of surgery. Postoperative shoulder CT scans were performed at an average of 14 weeks (range, 10-21 weeks). Scapulohumeral subluxation and glenoid version and inclination were measured in 3D, on both pre- and post-operative CT scans, using the same reliable quantitative method.
There was a significant decrease in scapulohumeral subluxation from 49±12% preoperatively to 22±17% postoperatively (p=0.0039), with a large effect size (Cohen's d=1.89). Preoperative glenoid version was corrected from -17.3±9.4 degrees to -5.2±7.5 degrees postoperatively. The absolute difference between the postoperative and surgically planned version and inclination was 5.4±3.6 degrees and 3.3±2.0 degrees, respectively.
The combined use of PAG implants with 3D preoperative planning and PSI results in a significant decrease in short-term PSH and glenoid version in patients with asymmetric posterior glenoid wear. We suggest that such implants should not be limited to posterior augmentation, because glenoid deficiency can also be observed in other glenoid sectors.
IV, Basic science study.
Keywords
Anatomic total shoulder arthroplasty, Glenoid version, Patient-specific instrumentation, Posterior augmented glenoid implant, Scapulohumeral subluxation
Pubmed
Web of science
Create date
25/04/2020 20:01
Last modification date
30/10/2020 6:26
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