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Shoulder arthroplasty to address the sequelae of anterior instability arthropathy and stabilization procedures: systematic review and meta-analysis

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

Chronic anterior glenohumeral joint instability is a common situation and can lead to progressive cartilage deterioration and ultimately instability arthopathy. Progressive cartilage deterioration can occur despite conservative or surgical treatment and the sequelae of these conditions are often addressed with total shoulder arthroplasty. Aims of the present study were to analyze the available literature to describe the technical aspects of this particular operation and to report outcomes and complication rates. The hypothesis was that shoulder arthropalsty in the sequelae of instability had lower outcomes and higher complication rates than arthroplasties for primary arthritis.

Methods

A systematic review of the literature was performed, in accordance with the PRISMA guidelines. PubMed, Ovid, Cochrane Reviews, and Google Scholar were comprehensively searched using a combination of the following keywords: shoulder arthroplasty, reverse shoulder arthroplasty, dislocation arthropathy, capsulorrhaphy arthropathy and stabilization procedures.

Results

Thirteen studies with 365 patients met inclusion criteria. Since 13 patients were lost to follow-up, 352 were reviewed at an average follow-up of 53.4 months. The average Constant–Murley (CM) and American Shoulder and Elbow Society (ASES) scores improved from 35.6 and 35.7 to 72.7 and 77, respectively. The overall complication rate was 25.7% and the reoperation rate was 18.5%. Radiographs at follow-up revealed radiolucent lines on the humerus in 12.4% of cases and radiolucent lines or notching on the glenoid side in 22.7% of cases. The average Methodological Index for Non-randomized Studies Score (MINORS) was 12.9 for non-comparative studies and 21.3 for comparative studies.

Conclusion

Shoulder arthroplasty to address the sequelae of instability arthropathy and stabilization procedures can be a challenging procedure as a consequence of the distorted anatomy and severe glenohumeral joint pathology. Complication and reoperation rates are higher compared to shoulder arthroplasty for primary glenohumeral joint arthritis; however, the difference is not statistically significant. When reverse shoulder arthroplasties (RSA) were considered as a subgroup and compared to anatomic shoulder replacements (total shoulders and hemiarthroplasties), they showed a lower revision rate.

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Authors and Affiliations

  1. Casa Di Cura Villa Betania, Rome, Italy

    Simone Cerciello

  2. Marrelli Hospital, Crotone, Italy

    Simone Cerciello

  3. Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Campobasso, Italy

    Katia Corona

  4. Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX, USA

    Brent Joseph Morris

  5. Centro di chirurgia della spalla e del gomito, Ospedale Civile Cervesi, Cattolica, Italy

    Paolo Paladini & Giovanni Merolla

  6. Policlinico Universitario Di Modena, Università Degli Studi Di Modena E Reggio Emilia, Modena, Italy

    Giuseppe Porcellini

Authors
  1. Simone Cerciello
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  2. Katia Corona
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  3. Brent Joseph Morris
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  4. Paolo Paladini
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  6. Giovanni Merolla
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Correspondence to Katia Corona.

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Cerciello, S., Corona, K., Morris, B.J. et al. Shoulder arthroplasty to address the sequelae of anterior instability arthropathy and stabilization procedures: systematic review and meta-analysis. Arch Orthop Trauma Surg 140, 1891–1900 (2020). https://doi.org/10.1007/s00402-020-03400-y

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