The effects of glenoid wear patterns on patients with osteoarthritis in total shoulder arthroplasty: an assessment of outcomes and value

Michael M Hussey; Brandon M Steen; Michael C Cusick; Jacob L Cox; Scott T Marberry; Peter Simon; Benjamin J Cottrell; Brandon G Santoni; Mark A Frankle

doi:10.1016/j.jse.2014.09.043

The effects of glenoid wear patterns on patients with osteoarthritis in total shoulder arthroplasty: an assessment of outcomes and value

J Shoulder Elbow Surg. 2015 May;24(5):682-90. doi: 10.1016/j.jse.2014.09.043. Epub 2014 Dec 3.

Authors

Michael M Hussey¹, Brandon M Steen¹, Michael C Cusick¹, Jacob L Cox², Scott T Marberry², Peter Simon², Benjamin J Cottrell², Brandon G Santoni², Mark A Frankle³

Affiliations

¹ Shoulder and Elbow Service, Florida Orthopaedic Institute, Tampa, FL, USA.
² Phillip Spiegel Orthopaedic Research Laboratory, Foundation for Orthopaedic Research and Education, Tampa, FL, USA.
³ Shoulder and Elbow Service, Florida Orthopaedic Institute, Tampa, FL, USA. Electronic address: mfrankle@floridaortho.com.

PMID: 25487904
DOI: 10.1016/j.jse.2014.09.043

Abstract

Background: Despite the success of total shoulder arthroplasty (TSA), concerns remain about the longevity of the implant, in particular, glenoid component survivorship. The purpose of this study was to determine whether preoperative glenoid wear patterns affect clinical outcomes and value in patients undergoing TSA.

Methods: A comparative cohort study was conducted of 309 patients with a total of 344 TSA procedures, performed for primary glenohumeral osteoarthritis. Computed tomography scans were obtained in all patients, with preoperative glenoid wear pattern characterized as either concentric (n = 196; follow-up time, 49.2 months) or eccentric (n = 148; follow-up time, 52.3 months) according to a modified Levine classification. A clinical, radiographic, and economic assessment was performed between the 2 wear patterns.

Results: There was no significant difference in American Shoulder and Elbow Surgeons (ASES) score in the concentric group (80.8 ± 20.8) compared with the eccentric group (77.6 ± 21.2) at final follow-up (P = .159). Range of motion and final visual analog scale for pain score were similar between the 2 groups. Radiographic evidence of gross glenoid loosening was significantly lower in the concentric group [11 of 195 (5.6%)] compared with the eccentric group [18 of 147 (12.2%)] (P = .030). Revision rates were similar between the concentric group [4 of 195 (2.0%)] and the eccentric group [3 of 147 (2.0%)]. A value assessment also showed no significant difference between the concentric and eccentric groups [concentric 26.1 vs. eccentric 25.5 (ΔASES score/$10,000 hospital cost) (P = .479)].

Conclusions: Similar clinical results and value can be expected with both concentric and eccentric glenoid wear patterns in TSA. Concerns arise, however, as the eccentric group demonstrated a more than 2-fold increased rate of glenoid component loosening compared with the concentric group.

Keywords: Total shoulder arthroplasty; concentric; eccentric; glenohumeral osteoarthritis; glenoid wear.

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement* / adverse effects
Female
Follow-Up Studies
Glenoid Cavity / diagnostic imaging*
Humans
Male
Middle Aged
Osteoarthritis / complications
Osteoarthritis / surgery*
Pain Measurement
Prosthesis Failure
Range of Motion, Articular
Reoperation
Retrospective Studies
Shoulder Joint / surgery*
Shoulder Pain / etiology
Tomography, X-Ray Computed
Treatment Outcome