Outcomes After Anatomic and Reverse Shoulder Arthroplasty for the Treatment of Glenohumeral Osteoarthritis: A Propensity Score-Matched Analysis.
Journal
The Journal of bone and joint surgery. American volume
ISSN: 1535-1386
Titre abrégé: J Bone Joint Surg Am
Pays: United States
ID NLM: 0014030
Informations de publication
Date de publication:
03 08 2022
03 08 2022
Historique:
pubmed:
23
7
2022
medline:
10
8
2022
entrez:
22
7
2022
Statut:
ppublish
Résumé
Reverse shoulder arthroplasty (RSA) is increasingly being utilized for the treatment of primary osteoarthritis. However, limited data are available regarding the outcomes of RSA as compared with anatomic total shoulder arthroplasty (TSA) in the setting of osteoarthritis. We performed a retrospective matched-cohort study of patients who had undergone TSA and RSA for the treatment of primary osteoarthritis and who had a minimum of 2 years of follow-up. Patients were propensity score-matched by age, sex, body mass index (BMI), preoperative American Shoulder and Elbow Surgeons (ASES) score, preoperative active forward elevation, and Walch glenoid morphology. Baseline patient demographics and clinical outcomes, including active range of motion, ASES score, Single Assessment Numerical Evaluation (SANE), and visual analog scale (VAS) for pain, were collected. Clinical and radiographic complications were evaluated. One hundred and thirty-four patients (67 patients per group) were included; the mean duration of follow-up (and standard deviation) was 30 ± 10.7 months. No significant differences were found between the TSA and RSA groups in terms of the baseline or final VAS pain score (p = 0.99 and p = 0.99, respectively), ASES scores (p = 0.99 and p = 0.49, respectively), or SANE scores (p = 0.22 and p = 0.73, respectively). TSA was associated with significantly better postoperative active forward elevation (149° ± 13° versus 142° ± 15°; p = 0.003), external rotation (63° ± 14° versus 57° ± 18°; p = 0.02), and internal rotation (≥L3) (68.7% versus 37.3%; p < 0.001); however, there were only significant baseline-to-postoperative improvements in internal rotation (gain of ≥4 levels in 53.7% versus 31.3%; p = 0.009). The overall complication rate was 4.5% (6 of 134), with no significant difference between TSA and RSA (p = 0.99). Radiolucent lines were observed in association with 14.9% of TSAs, with no gross glenoid loosening. One TSA (1.5%) was revised to RSA for the treatment of a rotator cuff tear. No loosening or revision was encountered in the RSA group. When performed for the treatment of osteoarthritis, TSA and RSA resulted in similar short-term patient-reported outcomes, with better postoperative range of motion after TSA. Longer follow-up is needed to determine the ultimate value of RSA in the setting of osteoarthritis. Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.
Sections du résumé
BACKGROUND
Reverse shoulder arthroplasty (RSA) is increasingly being utilized for the treatment of primary osteoarthritis. However, limited data are available regarding the outcomes of RSA as compared with anatomic total shoulder arthroplasty (TSA) in the setting of osteoarthritis.
METHODS
We performed a retrospective matched-cohort study of patients who had undergone TSA and RSA for the treatment of primary osteoarthritis and who had a minimum of 2 years of follow-up. Patients were propensity score-matched by age, sex, body mass index (BMI), preoperative American Shoulder and Elbow Surgeons (ASES) score, preoperative active forward elevation, and Walch glenoid morphology. Baseline patient demographics and clinical outcomes, including active range of motion, ASES score, Single Assessment Numerical Evaluation (SANE), and visual analog scale (VAS) for pain, were collected. Clinical and radiographic complications were evaluated.
RESULTS
One hundred and thirty-four patients (67 patients per group) were included; the mean duration of follow-up (and standard deviation) was 30 ± 10.7 months. No significant differences were found between the TSA and RSA groups in terms of the baseline or final VAS pain score (p = 0.99 and p = 0.99, respectively), ASES scores (p = 0.99 and p = 0.49, respectively), or SANE scores (p = 0.22 and p = 0.73, respectively). TSA was associated with significantly better postoperative active forward elevation (149° ± 13° versus 142° ± 15°; p = 0.003), external rotation (63° ± 14° versus 57° ± 18°; p = 0.02), and internal rotation (≥L3) (68.7% versus 37.3%; p < 0.001); however, there were only significant baseline-to-postoperative improvements in internal rotation (gain of ≥4 levels in 53.7% versus 31.3%; p = 0.009). The overall complication rate was 4.5% (6 of 134), with no significant difference between TSA and RSA (p = 0.99). Radiolucent lines were observed in association with 14.9% of TSAs, with no gross glenoid loosening. One TSA (1.5%) was revised to RSA for the treatment of a rotator cuff tear. No loosening or revision was encountered in the RSA group.
CONCLUSIONS
When performed for the treatment of osteoarthritis, TSA and RSA resulted in similar short-term patient-reported outcomes, with better postoperative range of motion after TSA. Longer follow-up is needed to determine the ultimate value of RSA in the setting of osteoarthritis.
LEVEL OF EVIDENCE
Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.
Identifiants
pubmed: 35867705
doi: 10.2106/JBJS.21.00982
pii: 00004623-202208030-00005
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1362-1369Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2022 by The Journal of Bone and Joint Surgery, Incorporated.
Déclaration de conflit d'intérêts
Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article ( http://links.lww.com/JBJS/H24 ).
Références
Best MJ, Aziz KT, Wilckens JH, McFarland EG, Srikumaran U. Increasing incidence of primary reverse and anatomic total shoulder arthroplasty in the United States. J Shoulder Elbow Surg. 2021 May;30(5):1159-66.
Rabinowitz J, Kothandaraman V, Lin J, Li X, Friedman RJ, Eichinger JK. Utilization of shoulder arthroplasty in the United States. An analysis of current trends and future predictions. Seminars in Arthroplasty: JSES. 2020 Sep;30(3):200-9.
Wagner ER, Farley KX, Higgins I, Wilson JM, Daly CA, Gottschalk MB. The incidence of shoulder arthroplasty: rise and future projections compared with hip and knee arthroplasty. J Shoulder Elbow Surg. 2020 Dec;29(12):2601-9.
Lindbloom BJ, Christmas KN, Downes K, Simon P, McLendon PB, Hess AV 2nd, Mighell MA, Frankle MA. Is there a relationship between preoperative diagnosis and clinical outcomes in reverse shoulder arthroplasty? An experience in 699 shoulders. J Shoulder Elbow Surg. 2019 Jun;28(6S):S110-7.
Boileau P, Watkinson D, Hatzidakis AM, Hovorka I. Neer Award 2005: The Grammont reverse shoulder prosthesis: results in cuff tear arthritis, fracture sequelae, and revision arthroplasty. J Shoulder Elbow Surg. 2006 Sep-Oct;15(5):527-40.
Mizuno N, Denard PJ, Raiss P, Walch G. Reverse total shoulder arthroplasty for primary glenohumeral osteoarthritis in patients with a biconcave glenoid. J Bone Joint Surg Am. 2013 Jul 17;95(14):1297-304.
Waterman BR, Dean RS, Naylor AJ, Otte RS, Sumner-Parilla SA, Romeo AA, Nicholson GP. Comparative Clinical Outcomes of Reverse Total Shoulder Arthroplasty for Primary Cuff Tear Arthropathy Versus Severe Glenohumeral Osteoarthritis With Intact Rotator Cuff: A Matched-Cohort Analysis. J Am Acad Orthop Surg. 2020 Dec 1;28(23):e1042-8.
Polisetty TS, Colley R, Levy JC. Value Analysis of Anatomic and Reverse Shoulder Arthroplasty for Glenohumeral Osteoarthritis with an Intact Rotator Cuff. J Bone Joint Surg Am. 2021 May 19;103(10):913-20.
Steen BM, Cabezas AF, Santoni BG, Hussey MM, Cusick MC, Kumar AG, Frankle MA. Outcome and value of reverse shoulder arthroplasty for treatment of glenohumeral osteoarthritis: a matched cohort. J Shoulder Elbow Surg. 2015 Sep;24(9):1433-41.
Denard PJ, Raiss P, Sowa B, Walch G. Mid- to long-term follow-up of total shoulder arthroplasty using a keeled glenoid in young adults with primary glenohumeral arthritis. J Shoulder Elbow Surg. 2013 Jul;22(7):894-900.
Sowa B, Bochenek M, Bülhoff M, Zeifang F, Loew M, Bruckner T, Raiss P. The medium- and long-term outcome of total shoulder arthroplasty for primary glenohumeral osteoarthritis in middle-aged patients. Bone Joint J. 2017 Jul;99-B(7):939-43.
Singh JA, Sperling JW, Cofield RH. Revision surgery following total shoulder arthroplasty: analysis of 2588 shoulders over three decades (1976 to 2008). J Bone Joint Surg Br. 2011 Nov;93(11):1513-7.
Wright MA, Keener JD, Chamberlain AM. Comparison of Clinical Outcomes After Anatomic Total Shoulder Arthroplasty and Reverse Shoulder Arthroplasty in Patients 70 Years and Older With Glenohumeral Osteoarthritis and an Intact Rotator Cuff. J Am Acad Orthop Surg. 2020 Mar 1;28(5):e222-9.
Evans JP, Batten T, Bird J, Thomas WJ, Kitson JB, Smith CD. Survival of the Aequalis total shoulder replacement at a minimum 20-year follow-up: a clinical and radiographic study. J Shoulder Elbow Surg. 2021 Oct;30(10):2355-60.
McLendon PB, Schoch BS, Sperling JW, Sánchez-Sotelo J, Schleck CD, Cofield RH. Survival of the pegged glenoid component in shoulder arthroplasty: part II. J Shoulder Elbow Surg. 2017 Aug;26(8):1469-76.
Young AA, Walch G, Pape G, Gohlke F, Favard L. Secondary rotator cuff dysfunction following total shoulder arthroplasty for primary glenohumeral osteoarthritis: results of a multicenter study with more than five years of follow-up. J Bone Joint Surg Am. 2012 Apr 18;94(8):685-93.
Parada SA, Flurin PH, Wright TW, Zuckerman JD, Elwell JA, Roche CP, Friedman RJ. Comparison of complication types and rates associated with anatomic and reverse total shoulder arthroplasty. J Shoulder Elbow Surg. 2021 Apr;30(4):811-8.
Brown JS, Gordon RJ, Peng Y, Hatton A, Page RS, Macgroarty KA. Lower operating volume in shoulder arthroplasty is associated with increased revision rates in the early postoperative period: long-term analysis from the Australian Orthopaedic Association National Joint Replacement Registry. J Shoulder Elbow Surg. 2020 Jun;29(6):1104-14.
Bercik MJ, Kruse K 2nd, Yalizis M, Gauci MO, Chaoui J, Walch G. A modification to the Walch classification of the glenoid in primary glenohumeral osteoarthritis using three-dimensional imaging. J Shoulder Elbow Surg. 2016 Oct;25(10):1601-6.
Chen JW, Maldonado DR, Kowalski BL, Miecznikowski KB, Kyin C, Gornbein JA, Domb BG. Best Practice Guidelines for Propensity Score Methods in Medical Research: Consideration on Theory, Implementation, and Reporting. A Review. Arthroscopy. 2022 Feb;38(2):632-42.
Lazarus MD, Jensen KL, Southworth C, Matsen FA 3rd. The radiographic evaluation of keeled and pegged glenoid component insertion. J Bone Joint Surg Am. 2002 Jul;84(7):1174-82.
Simovitch R, Flurin PH, Wright T, Zuckerman JD, Roche CP. Quantifying success after total shoulder arthroplasty: the substantial clinical benefit. J Shoulder Elbow Surg. 2018 May;27(5):903-11.
Simovitch R, Flurin PH, Wright T, Zuckerman JD, Roche CP. Quantifying success after total shoulder arthroplasty: the minimal clinically important difference. J Shoulder Elbow Surg. 2018 Feb;27(2):298-305.
Schairer WW, Nwachukwu BU, Lyman S, Craig EV, Gulotta LV. National utilization of reverse total shoulder arthroplasty in the United States. J Shoulder Elbow Surg. 2015 Jan;24(1):91-7.
Schoch BS, Wright TW, Zuckerman JD, Bolch C, Flurin PH, Roche C, King JJ. Glenoid component lucencies are associated with poorer patient-reported outcomes following anatomic shoulder arthroplasty. J Shoulder Elbow Surg. 2019 Oct;28(10):1956-63.
Bartels DW, Marigi E, Sperling JW, Sanchez-Sotelo J. Revision Reverse Shoulder Arthroplasty for Anatomical Glenoid Component Loosening Was Not Universally Successful: A Detailed Analysis of 127 Consecutive Shoulders. J Bone Joint Surg Am. 2021 May 19;103(10):879-86.
Collin P, Hervé A, Walch G, Boileau P, Muniandy M, Chelli M. Mid-term results of reverse shoulder arthroplasty for glenohumeral osteoarthritis with posterior glenoid deficiency and humeral subluxation. J Shoulder Elbow Surg. 2019 Oct;28(10):2023-30.