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Does prosthetic humeral articular surface positioning associate with outcome after total shoulder arthroplasty?
- Source :
-
Journal of shoulder and elbow surgery [J Shoulder Elbow Surg] 2018 May; Vol. 27 (5), pp. 863-870. Date of Electronic Publication: 2017 Dec 27. - Publication Year :
- 2018
-
Abstract
- Background: The purpose of this study was to determine the effect of humeral articular component positioning on changes in patient-reported outcomes after anatomic total shoulder arthroplasty.<br />Methods: This was a retrospective series of consecutive patients at 2 high-volume referral centers. The study included patients with (1) a preoperative and postoperative radiograph demonstrating a perfect or nearly perfect profile of the humerus and implant and (2) Simple Shoulder Test, visual analog scale for pain, and American Society of Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment scores preoperatively and at greater than 2 years postoperatively. Head height, head diameter, tuberosity-to-head height distance, inclination, and medial offset of the center of rotation (COR) were measured preoperatively and postoperatively. Distance and direction from the ideal COR to the reconstructed center of rotation was measured. Measurements were correlated with improvement in functional outcomes.<br />Results: The study included 95 patients, aged 66 ± 9 years, with a mean follow-up of 4.3 ± 1.7 years. An a priori power analysis suggested that a sample size of 95 patients provided 80% power to detect correlations of R <superscript>2</superscript> = 0.07. The COR shift was >2 mm in 62% of patients and >4 mm 15%. Thirty-two percent had a change of ASES of <21 points. On multivariate analysis, there were no significant associations between any change in measured prosthetic radiographic parameters and changes in the visual analog scale, Simple Shoulder Test, or ASES scores (P > .05).<br />Conclusion: In this retrospective analysis of total shoulder arthroplasty in which most components were well positioned, humeral component positioning did not associate with change in postoperative outcomes. These findings should be prospectively confirmed.<br /> (Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Female
Humans
Humerus surgery
Male
Middle Aged
Osteoarthritis diagnosis
Postoperative Period
Prosthesis Design
Radiography
Retrospective Studies
Shoulder Joint surgery
Treatment Outcome
Visual Analog Scale
Arthroplasty, Replacement, Shoulder methods
Humerus diagnostic imaging
Osteoarthritis surgery
Pain, Postoperative diagnosis
Range of Motion, Articular physiology
Shoulder Joint diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1532-6500
- Volume :
- 27
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of shoulder and elbow surgery
- Publication Type :
- Academic Journal
- Accession number :
- 29289492
- Full Text :
- https://doi.org/10.1016/j.jse.2017.10.038