Stemless Anatomic and Reverse Shoulder Arthroplasty in Patients under 55 years of age with Primary Glenohumeral Osteoarthritis: An analysis of the Australian Orthopaedic Association National Joint Replacement Registry at five years.

Anatomic shoulder arthroplasty Hemiarthroplasty Joint Registry Osteoarthritis Reverse shoulder arthroplasty Shoulder Survival Young Adults

Journal

Journal of shoulder and elbow surgery
ISSN: 1532-6500
Titre abrégé: J Shoulder Elbow Surg
Pays: United States
ID NLM: 9206499

Informations de publication

Date de publication:
12 Sep 2024
Historique:
received: 06 03 2024
revised: 27 06 2024
accepted: 25 07 2024
medline: 15 9 2024
pubmed: 15 9 2024
entrez: 14 9 2024
Statut: aheadofprint

Résumé

Primary glenohumeral osteoarthritis in young patients poses challenging treatment decisions. Arthroplasty options have different failure profiles and implant survivorship patterns. This registry study aims to analyze the cumulative per cent revision rate (CPR) of different types of arthroplasties conducted for primary osteoarthritis in patients under 55 years of age. This comparative observational national registry study included all shoulder arthroplasty for osteoarthritis in patients under 55 years of age undertaken between January 1 2111 primary shoulder arthroplasties were compared. Glenoid erosion is the predominant cause of revision for humeral resurfacing (29.8%) and hemiarthroplasty (35.5%). Instability is the predominant cause of revision for stemmed anatomic total shoulder arthroplasty (ATSA) and reverse total shoulder arthroplasty (RTSA), while loosening is the predominant cause of revision for stemless ATSA. The 6-year CPR is 12.8% for humeral resurfacing (HRA), 14.1% for hemiarthroplasty (HA), 12.4% for stemmed (ATSA), 7.0% for stemless ATSA, and 6.5% for (RTSA). Stemmed ATSA had a higher revision rate than RTSA (entire period HR=2.04 (95% confidence interval (CI) 1.16, 3.57), p=0.012). In contrast, the revision rate of stemless ATSA was not different from RTSA (HR =1.05 (95% CI 0.51, 2.19), p=0.889). Males outnumber females for all shoulder arthroplasty categories. RTSA and stemless ATSA are viable options in young patients with primary osteoarthritis. Their short-to medium-term revision rates are comparable to those of older patients and lower than those associated with HRA, HA, and stemmed ATSA. In the predominantly male patient population under the age of 55, reverse shoulder arthroplasty and stemless ATSA have a lower short-term revision risk than stemmed ATSA.

Sections du résumé

BACKGROUND BACKGROUND
Primary glenohumeral osteoarthritis in young patients poses challenging treatment decisions. Arthroplasty options have different failure profiles and implant survivorship patterns. This registry study aims to analyze the cumulative per cent revision rate (CPR) of different types of arthroplasties conducted for primary osteoarthritis in patients under 55 years of age.
METHODS METHODS
This comparative observational national registry study included all shoulder arthroplasty for osteoarthritis in patients under 55 years of age undertaken between January 1
RESULTS RESULTS
2111 primary shoulder arthroplasties were compared. Glenoid erosion is the predominant cause of revision for humeral resurfacing (29.8%) and hemiarthroplasty (35.5%). Instability is the predominant cause of revision for stemmed anatomic total shoulder arthroplasty (ATSA) and reverse total shoulder arthroplasty (RTSA), while loosening is the predominant cause of revision for stemless ATSA. The 6-year CPR is 12.8% for humeral resurfacing (HRA), 14.1% for hemiarthroplasty (HA), 12.4% for stemmed (ATSA), 7.0% for stemless ATSA, and 6.5% for (RTSA). Stemmed ATSA had a higher revision rate than RTSA (entire period HR=2.04 (95% confidence interval (CI) 1.16, 3.57), p=0.012). In contrast, the revision rate of stemless ATSA was not different from RTSA (HR =1.05 (95% CI 0.51, 2.19), p=0.889). Males outnumber females for all shoulder arthroplasty categories.
DISCUSSION CONCLUSIONS
RTSA and stemless ATSA are viable options in young patients with primary osteoarthritis. Their short-to medium-term revision rates are comparable to those of older patients and lower than those associated with HRA, HA, and stemmed ATSA.
CONCLUSION CONCLUSIONS
In the predominantly male patient population under the age of 55, reverse shoulder arthroplasty and stemless ATSA have a lower short-term revision risk than stemmed ATSA.

Identifiants

DOI: 10.1016/j.jse.2024.07.032 PMID: 39276846
pubmed: 39276846
pii: S1058-2746(24)00624-4
doi: 10.1016/j.jse.2024.07.032
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Auteurs

Mohammad Jomaa (M)

Queensland Unit for Advanced Shoulder Research QUASR, Queensland University of Technology, Brisbane, QLD, Australia.

Helen Ingoe (H)

Queensland Unit for Advanced Shoulder Research QUASR, Queensland University of Technology, Brisbane, QLD, Australia.

Freek Hollman (F)

Queensland Unit for Advanced Shoulder Research QUASR, Queensland University of Technology, Brisbane, QLD, Australia.

Roberto Pareyón (R)

Queensland Unit for Advanced Shoulder Research QUASR, Queensland University of Technology, Brisbane, QLD, Australia.

Sarah L Whitehouse (SL)

Queensland Unit for Advanced Shoulder Research QUASR, Queensland University of Technology, Brisbane, QLD, Australia.

Peiyao Du (P)

South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia.

David Rj Gill (DR)

Australian Orthopaedic Association National Joint Replacement Registry, Adelaide, SA, Australia.

Jashint Maharaj (J)

Queensland Unit for Advanced Shoulder Research QUASR, Queensland University of Technology, Brisbane, QLD, Australia; Greenslopes Private Hospital, Brisbane, QLD, Australia.

Ashish Gupta (A)

Queensland Unit for Advanced Shoulder Research QUASR, Queensland University of Technology, Brisbane, QLD, Australia; Greenslopes Private Hospital, Brisbane, QLD, Australia.

Kenneth Cutbush (K)

Queensland Unit for Advanced Shoulder Research QUASR, Queensland University of Technology, Brisbane, QLD, Australia; University of Queensland, Brisbane, QLD, Australia. Electronic address: research@kennethcutbush.com.

Classifications MeSH