The medium- and long-term outcome of total shoulder arthroplasty for primary glenohumeral osteoarthritis in middle-aged patients

Aims: Promising medium-term results from total shoulder arthroplasty (TSA) have been reported for the treatment of primary osteoarthritis in young and middle-aged patients. The aim of this study was to evaluate the long-term functional and radiological outcome of TSA in the middle-aged patient.Patie...

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Hauptverfasser: Sowa, Boris (VerfasserIn) , Bülhoff, Matthias (VerfasserIn) , Zeifang, Felix (VerfasserIn) , Loew, Markus (VerfasserIn) , Bruckner, Thomas (VerfasserIn) , Raiss, Patric (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 1 July 2017
In: The bone & joint journal
Year: 2017, Jahrgang: 99-B, Heft: 7, Pages: 939-943
ISSN:2049-4408
DOI:10.1302/0301-620X.99B7.BJJ-2016-1365.R1
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1302/0301-620X.99B7.BJJ-2016-1365.R1
Verlag, Volltext: https://online.boneandjoint.org.uk/doi/full/10.1302/0301-620X.99B7.BJJ-2016-1365.R1
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Verfasserangaben:B. Sowa, M. Bochenek, M. Bülhoff, F. Zeifang, M. Loew, T. Bruckner, P. Raiss

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520 |a Aims: Promising medium-term results from total shoulder arthroplasty (TSA) have been reported for the treatment of primary osteoarthritis in young and middle-aged patients. The aim of this study was to evaluate the long-term functional and radiological outcome of TSA in the middle-aged patient.Patients and MethodsThe data of all patients from the previous medium-term study were available. At a mean follow-up of 13 years (8 to 17), we reviewed 21 patients (12 men, nine women, 21 shoulders) with a mean age of 55 years (37 to 60). The Constant-Murley score (CS) with its subgroups and subjective satisfaction were measured. Radiological signs of implant loosening were analysed. Results: Two shoulders (two patients) were revised and in two shoulders of two different patients, revision surgery was recommended. The mean CS increased from 23.3 (10 to 45) pre-operatively to 56.5 (26 to 81; p < 0.0001), but with a decrease in CS from 62.8 (38 to 93) to 56.5 (26 to 81) between medium- and long-term follow-up (p = 0.01). Without revision surgery, 18 patients (95%) rated their result as good or very good.The mean radiolucent line score for the glenoid components increased from 1.8 (0 to 6) to 8.2 (2 to 18) between medium- and long-term follow-up (p < 0.001). Conclusion: TSA in young and middle-aged patients leads to improvement in clinical function and a relatively high satisfaction rate. However, clinical or radiological glenoid loosening worsens in the long term. Further studies are needed to optimise the treatment options in this patient population. 
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