Factors Associated with Success of Ream-and-Run Arthroplasty at a Minimum of Five Years.

Abstract

Ream-and-run arthroplasty offers improvement in shoulder pain and function for patients with primary glenohumeral arthritis who wish to avoid limitations associated with a polyethylene glenoid component. Longer-term clinical outcome assessments of the ream-and-run procedure are sparse in the literature. This study aims to present minimum 5-year functional outcomes in a large cohort following ream-and-run arthroplasty to determine factors associated with clinical success and reoperation. Patients undergoing ream-and-run surgery with a minimum of 5-years and mean of 7.6 ± 2.1 years of follow-up were collected through a retrospective review of a prospectively maintained database from a single academic institution. To assess clinical outcomes, the Simple Shoulder Test (SST) was administered and assessed for minimum clinically important difference achievement as well as the necessity for open revision surgery. Factors associated with a p<0.1 on univariate analysis were included in a multivariate analysis. A total of 201 patients of 228 patients (88%) consented for long-term follow-up were included in our analysis. Average age was 59.4 ± 8.8 years, and 93% of patients were male with the majority having the diagnosis of osteoarthritis (79%) or capsulorrhaphy arthropathy (10%). SST scores improved from a mean of 4.9 ± 2.5 preoperatively to a mean of 10.2 ± 2.6 at latest follow-up. 165 patients (82%) reached the minimal clinically important difference of the SST of 2.6. Male sex (p=0.020), non-diabetes (p=0.080), and lower preoperative SST (p<0.001) were included in the multivariate analysis. Male sex (p=0.010) and lower preoperative SST scores (p≤0.001) were associated with clinically important improvements in SST scores on the multivariate analysis. Twenty-two patients (11%) required open revision surgery. Younger age (p<0.001), female sex (p=0.055), and higher preoperative pain scores (p=0.023) were included in the multivariate analysis. Only younger age was predictive of open revision surgery (p=0.003). Ream and run arthroplasty can provide significant and clinically important improvements in clinical outcomes at minimum 5-year follow-up. Successful clinical outcomes were significantly associated with male sex and lower preoperative SST scores. Reoperation was more common in younger patients.