Outcomes of Shoulder Arthroplasty After Failure of Biological Resurfacing of the Glenohumeral Joint (SS-24B)

Abstract

Introduction This study reports the outcomes of patients undergoing total shoulder arthroplasty following failed management of degenerative joint disease with biological resurfacing of the glenoid. The purpose of this study is to report the results of patients who underwent biological resurfacing and were later converted to total shoulder arthroplasty (TSA). Methods Seven patients (mean age 37.4 ± 10.3 years) treated with biologic resurfacing of the glenoid using lateral meniscal allograft (5 patients) or human acellular dermal tissue matrix (2 patients) failed the procedure and were converted to TSA after an average of 2.0 ± 1.4 years. All patients were available for follow up at an average of 3.3 ± 1.8 years. Results Only limited improvement was observed post-conversion. Forward flexion and external rotation improved from 103.3° ± 34.4° and 28.3° ± 12.9° to 109.4° ± 52.9° and 41.0° ± 14.8°, respectively. The mean ASES, SST, and VAS scores for this group were 29.5 ± 12.1, 1.0 ± 1.4, and 6.25 ± 1.7 preoperatively and 38.3 ± 18.6, 3.7 ± 3.5, and 5.3 ± 1.9 postoperatively, respectively. The threshold of failure was set at an ASES score of Conclusion Biological interposition arthroplasty is designed to postpone the need for prosthetic glenoid components and thus delay the risks associated with polyethylene glenoid implants such as component wear, fragmentation, and glenoid loosening or disassociation. The poor clinical outcomes seen in patients who are converted to a TSA after failure of biological resurfacing suggests that TSA may be the preferred primary procedure in young patients with severe glenohumeral arthritis.