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Radiological and functional 24-month outcomes of resurfacing versus stemmed anatomic total shoulder arthroplasty

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Abstract

Purpose

This study compared clinical and radiographic outcomes of patients undergoing resurfacing total shoulder arthroplasty (TSA) with those treated with a stemmed TSA.

Methods

Patients with primary osteoarthritis who underwent humeral resurfacing (RES) or stemmed (STA) TSA were identified in our shoulder arthroplasty register for retrospective analysis. Standard radiographs and clinical/patient-rated assessments were made up to 24 months post-surgery. Implant revisions were assessed. Patients were frequency-matched in a 1:1 (RES:STA) ratio based on gender and age, and compared with regard to operation time and shoulder function (Constant, SPADI and Quick DASH scores). Mixed models with statistical adjustments were applied.

Results

From 2006 to 2014, 44 RES and 137 STA operations were performed in 157 patients; one and two revisions were recorded in the RES and STA group, respectively. The final matched cohort included a total of 69 patients and 37 operations per treatment group. Resurfacing TSA was 17 min shorter (95%CI: 5–28) compared to the stemmed procedure (p = 0.005). RES and STA patients showed significant functional improvement six months post-implantation, yet all measured scores did not differ between the groups at 2 years (p ≥ 0.131). The status of static centering of the humeral head, acromiohumeral distance, and a lack of signs of implant loosening were also similar between treatments.

Conclusion

Similar 24-month post-operative radiological and functional outcome is achieved by RES and STA patients, even with a shorter RES surgery time. Larger cohorts and longer follow-up are required to better assess implant survival.

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Authors and Affiliations

  1. Upper Extremities Department, Schulthess Clinic, Lengghalde 2, CH-8008, Zurich, Switzerland

    Michael C. Glanzmann, Christoph Kolling, Hans-Kaspar Schwyzer, Matthias Flury & Laurent Audigé

  2. Research and Development Department, Schulthess Clinic, Zurich, Switzerland

    Christoph Kolling & Laurent Audigé

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  1. Michael C. Glanzmann
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  2. Christoph Kolling
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  3. Hans-Kaspar Schwyzer
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  4. Matthias Flury
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Correspondence to Michael C. Glanzmann.

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The authors declare that they have no conflict of interest.

Funding

Support for this research was provided by Schulthess Clinic.

Ethical approval

The implementation of our data analysis was made in accordance with the ethical standards of the cantonal ethics committee of Zurich (KEK-ZH Nr. 2014–0483) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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C. Glanzmann, M., Kolling, C., Schwyzer, HK. et al. Radiological and functional 24-month outcomes of resurfacing versus stemmed anatomic total shoulder arthroplasty. International Orthopaedics (SICOT) 41, 375–384 (2017). https://doi.org/10.1007/s00264-016-3310-4

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  • DOI: https://doi.org/10.1007/s00264-016-3310-4

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