Abstract
BackgroundThe objective was to evaluate the short-term clinical and radiological outcomes following augmented anatomic total shoulder arthroplasty in patients with posterior glenoid deficiency.MethodsAn electronic search of EMBASE, MEDLINE, and PubMed identified studies reporting clinical and radiographic outcomes following augmented anatomic total shoulder arthroplasty among patients with posterior glenoid deficiency.ResultsNine studies including 312 shoulders underwent anatomic total shoulder arthroplasty using an augmented glenoid implant between 2015 and 2020. A statistically significant improvement in range of motion (ROM), visual analog scale (VAS), American Shoulder & Elbow Surgeons (ASES), Constant, University of California - Los Angeles and Simple Shoulder Test (SST) scores was demonstrated at mean follow-up of 37.1 months. Glenoid retroversion improved from 21.8° to 9.5°. At final follow-up, radiolucency was reported in 35.1% of shoulders. The 16° full-wedge augment led to higher and more severe radiographic lucency, while high peg perforation rates (44%) were observed among 5-mm augment stepped implants. The overall rate of complication was 2.6%. Rate of revision surgery was 1.9%.ConclusionsOverall, early- to mid-term outcomes following augmented anatomic total shoulder arthroplasty for posterior glenoid deficiency demonstrate good to excellent overall clinical results. More radiographic and clinical failures were reported in larger full wedge (16°) augments and stepped augments (5 mm). Prospective studies examining mid- and long-term outcomes will help further elucidate safety and efficacy of these relatively new implants.
Highlights
The overall incidence of shoulder arthroplasty is increasing at a greater rate than total hip and knee arthroplasty with predictive models estimating over 174,000 procedures performed annually by the year 2025.3 Anatomic total shoulder arthroplasty is indicated in primary glenohumeral joint osteoarthritis, inflammatory arthritis and post-traumatic arthritis.[4]
An electronic search using EMBASE, MEDLINE and PubMed was conducted through 4 February 2020 using the following MeSH search terms: ‘‘augmented glenoid,’’ ‘‘shoulder arthroplasty,’’ ‘‘arthroplasty,’’ ‘‘replacement,’’ ‘‘shoulder,’’ and ‘‘osteoarthritis.’’ Additional studies were identified by reviewing the reference lists of eligible articles
The current review demonstrates that the use of an augmented glenoid component to address severe posterior bone loss in patients undergoing Anatomic total shoulder arthroplasty (aTSA) is a promising solution to a challenging problem
Summary
Shoulder arthroplasty is the third most frequently performed joint replacement procedure in the United States.[1,2] The overall incidence of shoulder arthroplasty is increasing at a greater rate than total hip and knee arthroplasty with predictive models estimating over 174,000 procedures performed annually by the year 2025.3 Anatomic total shoulder arthroplasty (aTSA) is indicated in primary glenohumeral joint osteoarthritis, inflammatory arthritis and post-traumatic arthritis.[4]. The objective was to evaluate the short-term clinical and radiological outcomes following augmented anatomic total shoulder arthroplasty in patients with posterior glenoid deficiency. Methods: An electronic search of EMBASE, MEDLINE, and PubMed identified studies reporting clinical and radiographic outcomes following augmented anatomic total shoulder arthroplasty among patients with posterior glenoid deficiency. Results: Nine studies including 312 shoulders underwent anatomic total shoulder arthroplasty using an augmented glenoid implant between 2015 and 2020. The 16 full-wedge augment led to higher and more severe radiographic lucency, while high peg perforation rates (44%) were observed among 5-mm augment stepped implants. Conclusions: Overall, early- to mid-term outcomes following augmented anatomic total shoulder arthroplasty for posterior glenoid deficiency demonstrate good to excellent overall clinical results. More radiographic and clinical failures were reported in larger full wedge (16) augments and stepped augments (5 mm). Prospective studies examining mid- and long-term outcomes will help further elucidate safety and efficacy of these relatively new implants
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