Pre-operative factors affecting the indications for anatomical and reverse total shoulder arthroplasty in primary osteoarthritis and outcome comparison in patients aged seventy years and older

Abstract

Background

We evaluated the pre-operative factors affecting anatomical and reverse total shoulder arthroplasty (TSA and RTSA) indications in primary osteoarthritis and compared outcomes in patients aged 70 years and older.

Methods

Fifty-eight patients received a TSA with an all-polyethylene glenoid component (APGC) or an RTSA with/without glenoid lateralization and the same curved short-stem humeral component. Active anterior and lateral elevation (AAE, ALE), internal and external rotation (IR, ER), pain, and the Constant–Murley score (CS) were recorded pre and post-operatively. Pre-operative rotator cuff (RC) fatty infiltration (FI) and modified Walch glenoid morphology were assessed. Humeral and glenoid component radiological outcomes were recorded.

Results

RTSA were older than TSA patients (p = 0.006), had lower pre-operative AAE (p < 0.001), ALE (p < 0.001), IR (p = 0.002), pain (p = 0.008) and CS (p < 0.001), and greater supraspinatus FI (p < 0.001). At a mean of 28.8 months, both implants yielded significantly different post-operative scores and similar complication rates. Both groups achieved similar post-operative AAE, ER, and IR; ALE was higher in TSA (p = 0.006); and AAE and ALE delta scores were higher in RTSA (p = 0.045 and p = 0.033, respectively). Radiolucent line rates were higher around the TSA APGC than the RTSA baseplate (p = 0.001). High-grade RC FI adversely affected mobility improvement. Humeral cortical thinning was significantly higher in TSA (p = 0.001).

Conclusion

RTSA patients were older, had poorer pre-operative active mobility, and had greater RC FI than TSA. Both devices provided good mid-term clinical and ROM improvement.

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References

  1. 1.

    Steinhaus ME, Gowd AK, Hurwit DJ, Lieber AC, Liu JN (2019) Return to work after shoulder arthroplasty: a systematic review and meta-analysis. J Shoulder Elb Surg. https://doi.org/10.1016/j.jse.2018.12.011

    Article  PubMed  Google Scholar 

  2. 2.

    Roberson TA, Bentley JC, Griscom JT, Kissenberth MJ, Tolan SJ, Hawkins RJ, Tokish JM (2017) Outcomes of total shoulder arthroplasty in patients younger than 65 years: a systematic review. J Shoulder Elb Surg 26:1298–1306. https://doi.org/10.1016/j.jse.2016.12.069

    Article  Google Scholar 

  3. 3.

    Patel RB, Muh S, Okoroha KR, Wright TW, Flurin PH, Roche C, Zuckerman JD (2018) Results of total shoulder arthroplasty in patients aged 55 years or younger versus those older than 55 years: an analysis of 1135 patients with over 2 years of follow-up. J Shoulder Elb Surg. https://doi.org/10.1016/j.jse.2018.09.029

    Article  PubMed  Google Scholar 

  4. 4.

    Liu JN, Steinhaus ME, Garcia GH, Chang B, Fields K, Dines DM, Warren RF, Gulotta LV (2018) Return to sport after shoulder arthroplasty: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 26:100–112. https://doi.org/10.1007/s00167-017-4547-1

    Article  PubMed  Google Scholar 

  5. 5.

    Bryant D, Litchfield R, Sandow M, Gartsman GM, Guyatt G, Kirkley A (2005) A comparison of pain, strength, range of motion, and functional outcomes after hemiarthroplasty and total shoulder arthroplasty in patients with osteoarthritis of the shoulder. A systematic review and meta-analysis. J Bone Joint Surg Am 87:1947–1956. https://doi.org/10.2106/JBJS.D.02854

    Article  PubMed  Google Scholar 

  6. 6.

    Young AA, Walch G, Pape G, Gohlke F, Favard L (2012) 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 94:685–693. https://doi.org/10.2106/JBJS.J.00727

    Article  PubMed  Google Scholar 

  7. 7.

    Grammont PM, Baulot E (1993) Delta shoulder prosthesis for rotator cuff rupture. Orthopedics 16:65–68

    Article  CAS  PubMed  Google Scholar 

  8. 8.

    Shukla DR, McAnany S, Kim J, Overley S, Parsons BO (2016) Hemiarthroplasty versus reverse shoulder arthroplasty for treatment of proximal humeral fractures: a meta-analysis. J Shoulder Elb Surg 25:330–340. https://doi.org/10.1016/j.jse.2015.08.030

    Article  Google Scholar 

  9. 9.

    Erickson BJ, Bohl DD, Cole BJ, Verma NN, Nicholson G, Romeo AA, Harris JD (2018) Reverse total shoulder arthroplasty: indications and techniques across the world. Am J Orthop (Belle Mead NJ) 47. DOI https://doi.org/10.12788/ajo.2018.0079

  10. 10.

    Walch G, Moraga C, Young A, Castellanos-Rosas J (2012) Results of anatomic nonconstrained prosthesis in primary osteoarthritis with biconcave glenoid. J Shoulder Elb Surg 21:1526–1533. https://doi.org/10.1016/j.jse.2011.11.030

    Article  Google Scholar 

  11. 11.

    Moineau G, Levigne C, Boileau P, Young A, Walch G, French Society for S, Elbow (2012) Three-dimensional measurement method of arthritic glenoid cavity morphology: feasibility and reproducibility. Orthop Traumatol Surg Res 98:S139–S145. https://doi.org/10.1016/j.otsr.2012.06.007

    Article  PubMed  CAS  Google Scholar 

  12. 12.

    Walch G, Vezeridis PS, Boileau P, Deransart P, Chaoui J (2015) Three-dimensional planning and use of patient-specific guides improve glenoid component position: an in vitro study. J Shoulder Elb Surg 24:302–309. https://doi.org/10.1016/j.jse.2014.05.029

    Article  Google Scholar 

  13. 13.

    Gauci MO, Boileau P, Baba M, Chaoui J, Walch G (2016) Patient-specific glenoid guides provide accuracy and reproducibility in total shoulder arthroplasty. Bone Joint J 98-B:1080–1085. https://doi.org/10.1302/0301-620X.98B8.37257

    Article  PubMed  CAS  Google Scholar 

  14. 14.

    Luedke C, Kissenberth MJ, Tolan SJ, Hawkins RJ, Tokish JM (2018) Outcomes of anatomic total shoulder arthroplasty with B2 glenoids: a systematic review. JBJS Rev 6:e7. https://doi.org/10.2106/JBJS.RVW.17.00112

    Article  PubMed  Google Scholar 

  15. 15.

    Bercik MJ, Kruse K 2nd, Yalizis M, Gauci MO, Chaoui J, Walch G (2016) A modification to the Walch classification of the glenoid in primary glenohumeral osteoarthritis using three-dimensional imaging. J Shoulder Elb Surg 25:1601–1606. https://doi.org/10.1016/j.jse.2016.03.010

    Article  Google Scholar 

  16. 16.

    Chan K, Knowles NK, Chaoui J, Ferreira LM, Walch G, Athwal GS (2018) Is the Walch B3 glenoid significantly worse than the B2? Should Elb 10:256–261. https://doi.org/10.1177/1758573217724111

    Article  Google Scholar 

  17. 17.

    Chan K, Knowles NK, Chaoui J, Gauci MO, Ferreira LM, Walch G, Athwal GS (2017) Characterization of the Walch B3 glenoid in primary osteoarthritis. J Shoulder Elb Surg 26:909–914. https://doi.org/10.1016/j.jse.2016.10.003

    Article  Google Scholar 

  18. 18.

    Chin PC, Hachadorian ME, Pulido PA, Munro ML, Meric G, Hoenecke HR Jr (2015) Outcomes of anatomic shoulder arthroplasty in primary osteoarthritis in type B glenoids. J Shoulder Elb Surg 24:1888–1893. https://doi.org/10.1016/j.jse.2015.05.052

    Article  Google Scholar 

  19. 19.

    Boileau P, Morin-Salvo N, Gauci MO, Seeto BL, Chalmers PN, Holzer N, Walch G (2017) Angled BIO-RSA (bony-increased offset-reverse shoulder arthroplasty): a solution for the management of glenoid bone loss and erosion. J Shoulder Elb Surg 26:2133–2142. https://doi.org/10.1016/j.jse.2017.05.024

    Article  Google Scholar 

  20. 20.

    Point GM (2013) Total shoulder replacement—EU analysis and market forecasts. In. GlobalData

  21. 21.

    Porcellini G, Combi A, Merolla G, Bordini B, Stea S, Zanoli G, Paladini P (2018) The experience of the RIPO, a shoulder prosthesis registry with 6-year follow-up. Musculoskelet Surg 102:273–282. https://doi.org/10.1007/s12306-017-0529-1

    Article  PubMed  CAS  Google Scholar 

  22. 22.

    Implants RotOP (2014) Annual report 2016 Regione Emilia Romagna. In. RIPO

  23. 23.

    Chalmers PN, Salazar DH, Romeo AA, Keener JD, Yamaguchi K, Chamberlain AM (2018) Comparative utilization of reverse and anatomic total shoulder arthroplasty: a comprehensive analysis of a high-volume center. J Am Acad Orthop Surg 26:e504–e510. https://doi.org/10.5435/JAAOS-D-17-00075

    Article  PubMed  Google Scholar 

  24. 24.

    Mizuno N, Denard PJ, Raiss P, Walch G (2013) Reverse total shoulder arthroplasty for primary glenohumeral osteoarthritis in patients with a biconcave glenoid. J Bone Joint Surg Am 95:1297–1304. https://doi.org/10.2106/JBJS.L.00820

    Article  PubMed  Google Scholar 

  25. 25.

    Steen BM, Cabezas AF, Santoni BG, Hussey MM, Cusick MC, Kumar AG, Frankle MA (2015) Outcome and value of reverse shoulder arthroplasty for treatment of glenohumeral osteoarthritis: a matched cohort. J Shoulder Elb Surg 24:1433–1441. https://doi.org/10.1016/j.jse.2015.01.005

    Article  Google Scholar 

  26. 26.

    Wright MA, Keener JD, Chamberlain AM (2019) 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. https://doi.org/10.5435/JAAOS-D-19-00166

    Article  PubMed  Google Scholar 

  27. 27.

    Neer CS 2nd (1974) Replacement arthroplasty for glenohumeral osteoarthritis. J Bone Joint Surg Am 56:1–13

    Article  PubMed  Google Scholar 

  28. 28.

    Friedman RJ, Hawthorne KB, Genez BM (1992) The use of computerized tomography in the measurement of glenoid version. J Bone Joint Surg Am 74:1032–1037

    Article  CAS  PubMed  Google Scholar 

  29. 29.

    Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC (1994) Fatty muscle degeneration in cuff ruptures. Pre- and post-operative evaluation by CT scan. Clin Orthop Relat Res:78–83

  30. 30.

    Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C (1999) Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elb Surg 8:599–605

    Article  CAS  Google Scholar 

  31. 31.

    Boutsiadis A, Lenoir H, Denard PJ, Panisset JC, Brossard P, Delsol P, Guichard F, Barth J (2018) The lateralization and distalization shoulder angles are important determinants of clinical outcomes in reverse shoulder arthroplasty. J Shoulder Elb Surg 27:1226–1234. https://doi.org/10.1016/j.jse.2018.02.036

    Article  Google Scholar 

  32. 32.

    Boileau P, Moineau G, Roussanne Y, O'Shea K (2011) Bony increased-offset reversed shoulder arthroplasty: minimizing scapular impingement while maximizing glenoid fixation. Clin Orthop Relat Res 469:2558–2567. https://doi.org/10.1007/s11999-011-1775-4

    Article  PubMed  PubMed Central  Google Scholar 

  33. 33.

    Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res:160–164

  34. 34.

    Kibler WB, Sciascia A, Dome D (2006) Evaluation of apparent and absolute supraspinatus strength in patients with shoulder injury using the scapular retraction test. Am J Sports Med 34:1643–1647. https://doi.org/10.1177/0363546506288728

    Article  PubMed  Google Scholar 

  35. 35.

    Merolla G, De Santis E, Sperling JW, Campi F, Paladini P, Porcellini G (2010) Infraspinatus strength assessment before and after scapular muscles rehabilitation in professional volleyball players with scapular dyskinesis. J Shoulder Elb Surg 19:1256–1264. https://doi.org/10.1016/j.jse.2010.01.022

    Article  Google Scholar 

  36. 36.

    Molè D RO, Riand N, Levigne C, Walch G. (1999) Cemented glenoid components: results in osteoarthritis and rheumatoid arthritis. In: Walch G BP, editors. (ed) Shoulder arthroplasty. Springer-Verlag, Berlin. pp. 163-171

    Chapter  Google Scholar 

  37. 37.

    Sperling JW, Cofield RH, O'Driscoll SW, Torchia ME, Rowland CM (2000) Radiographic assessment of ingrowth total shoulder arthroplasty. J Shoulder Elb Surg 9:507–513

    Article  CAS  Google Scholar 

  38. 38.

    Schnetzke M, Coda S, Raiss P, Walch G, Loew M (2016) Radiologic bone adaptations on a cementless short-stem shoulder prosthesis. J Shoulder Elb Surg 25:650–657. https://doi.org/10.1016/j.jse.2015.08.044

    Article  Google Scholar 

  39. 39.

    Sperling JW, Cofield RH, Rowland CM (2000) Heterotopic ossification after total shoulder arthroplasty. J Arthroplast 15:179–182

    Article  CAS  Google Scholar 

  40. 40.

    Melis B, DeFranco M, Ladermann A, Mole D, Favard L, Nerot C, Maynou C, Walch G (2011) An evaluation of the radiological changes around the Grammont reverse geometry shoulder arthroplasty after eight to 12 years. J Bone Joint Surg (Br) 93:1240–1246. https://doi.org/10.1302/0301-620X.93B9.25926

    Article  CAS  Google Scholar 

  41. 41.

    Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Mole D (2004) Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Joint Surg (Br) 86:388–395

    Article  CAS  Google Scholar 

  42. 42.

    Crosby LA, Hamilton A, Twiss T (2011) Scapula fractures after reverse total shoulder arthroplasty: classification and treatment. Clin Orthop Relat Res 469:2544–2549. https://doi.org/10.1007/s11999-011-1881-3

    Article  PubMed  PubMed Central  Google Scholar 

  43. 43.

    Chalmers PN, Keener JD (2016) Expanding roles for reverse shoulder arthroplasty. Curr Rev Musculoskelet Med 9:40–48. https://doi.org/10.1007/s12178-016-9316-0

    Article  PubMed  PubMed Central  Google Scholar 

  44. 44.

    Merolla G, Ciaramella G, Fabbri E, Walch G, Paladini P, Porcellini G (2016) Total shoulder replacement using a bone ingrowth central peg polyethylene glenoid component: a prospective clinical and computed tomography study with short- to mid-term follow-up. Int Orthop 40:2355–2363. https://doi.org/10.1007/s00264-016-3255-7

    Article  PubMed  Google Scholar 

  45. 45.

    Griffin JW, Hadeed MM, Novicoff WM, Browne JA, Brockmeier SF (2014) Patient age is a factor in early outcomes after shoulder arthroplasty. J Shoulder Elb Surg 23:1867–1871. https://doi.org/10.1016/j.jse.2014.04.004

    Article  Google Scholar 

  46. 46.

    Bovonratwet P, Malpani R, Ondeck NT, Tyagi V, Grauer JN (2019) Elective total shoulder arthroplasty in octogenarians: a safe procedure. J Am Acad Orthop Surg 27:145–154. https://doi.org/10.5435/JAAOS-D-17-00364

    Article  PubMed  Google Scholar 

  47. 47.

    Merolla G, Walch G, Ascione F, Paladini P, Fabbri E, Padolino A, Porcellini G (2018) Grammont humeral design versus onlay curved-stem reverse shoulder arthroplasty: comparison of clinical and radiographic outcomes with minimum 2-year follow-up. J Shoulder Elb Surg 27:701–710. https://doi.org/10.1016/j.jse.2017.10.016

    Article  Google Scholar 

  48. 48.

    Lopez CD, Maier SP, Bloom ZJ, Shiu BB, Petkovic D, Jobin CM (2018) Outcomes of lesser tuberosity osteotomy in revision anatomic shoulder arthroplasty. J Shoulder Elb Surg 27:e219–e224. https://doi.org/10.1016/j.jse.2017.12.006

    Article  Google Scholar 

  49. 49.

    Rauck RC, Swarup I, Chang B, Dines DM, Warren RF, Gulotta LV, Henn RF 3rd (2018) Effect of pre-operative patient expectations on outcomes after reverse total shoulder arthroplasty. J Shoulder Elb Surg 27:e323–e329. https://doi.org/10.1016/j.jse.2018.05.026

    Article  Google Scholar 

  50. 50.

    Choate WS, Shanley E, Washburn R, Tolan SJ, Salim TI, Tadlock J, Shealy EC, Long CD, Crawford AE, Kissenberth MJ, Lonergan KT, Hawkins RJ, Tokish JM (2017) The incidence and effect of fatty atrophy, positive tangent sign, and rotator cuff tears on outcomes after total shoulder arthroplasty. J Shoulder Elb Surg 26:2110–2116. https://doi.org/10.1016/j.jse.2017.05.022

    Article  Google Scholar 

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Correspondence to Giovanni Merolla.

Ethics declarations

IRB approval was obtained from the institutional review board of the Coordinator Center in Cattolica, Italy, as part of a large Shoulder Arthroplasty database (Prot. No. 6478/20191.5/117 CEROM, Italy).

Conflict of interest

Gilles Walch, Vincenzo De Cupis, Francesco Franceschi, Claudio Ascani, and Giuseppe Porcellini are paid consultants for the Wright Medical Group.

The other authors, their immediate family, and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.

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Level of Evidence: Level III, Retrospective cohort design, Treatment study

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Merolla, G., De Cupis, M., Walch, G. et al. Pre-operative factors affecting the indications for anatomical and reverse total shoulder arthroplasty in primary osteoarthritis and outcome comparison in patients aged seventy years and older. International Orthopaedics (SICOT) 44, 1131–1141 (2020). https://doi.org/10.1007/s00264-020-04501-4

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Keywords

  • Anatomical
  • Reverse
  • Total shoulder arthroplasty
  • Primary osteoarthritis
  • Elderly