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Inlay Total Shoulder Arthroplasty For Primary Glenohumeral Arthritis

Inlay Total Shoulder Arthroplasty For Primary Glenohumeral Arthritis

John W. Uribe, MD, UNITED STATES John E. Zvijac, MD, UNITED STATES Luis A Vargas, MD, PhD, UNITED STATES David A. Porter, MD, UNITED STATES Anshul Saxena, BDS, PhD, UNITED STATES Matthias Schurhoff, MD, UNITED STATES Andrew Payomo, MD student, UNITED STATES

MIAMI ORTHOPEDIC AND SPORTS MEDICINE INSTITUTE, Coral Gables, Florida, UNITED STATES


2021 Congress   Abstract Presentation   5 minutes   Not yet rated

 

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Summary: Treatment with inlay total shoulder arthroplasty demonstrated meaningful functional improvement, excellent pain relief, and patient satisfaction in patients with advanced shoulder arthritis and various glenoid stages


Background

Anatomic total shoulder arthroplasty (TSA) with a non-spherical humeral head and inlay glenoid replacement has been introduced in the past, however clinical evidence remains limited. We hypothesized that patients with advanced glenohumeral arthritis demonstrate meaningful improvements.

Methods

Prospective patient-reported outcomes (PRO) included the American Shoulder and Elbow Surgeons Score (ASES), a pain visual analog scale (VAS-Pain), and satisfaction. Range of motion was compared to the preoperative status. A sensitivity analysis examined responder rates (RR) to literature TSA thresholds for minimal clinically important difference (MCID) and substantial clinical benefit (SCB). Glenohumeral staging and implant stability with zone-specific periprosthetic radiolucency were performed radiographically.

Results

Thirty-nine shoulders in 36 patients (3 bilateral) with a mean age of 65.9 years (26 males, 13 females) and a mean follow-up of 41.0 months, were included. 93% had Grade III osteoarthritis, 7% Grade II. Glenoid stages included A1 (25%), A2 (25%), B1 (22%), B2 (25%,) and C (3%). All PROs improved significantly (p<.001) with a mean ASES from 30.4 -77.1, a VAS-Pain from 8.1-1.5, and excellent (9.1/10) patient satisfaction. PRO related RRs for MCID and SCB were >85%. Forward elevation improved from 106.50-154.90, and external rotation from 21.90-50.80. One intraoperative glenoid rim fracture led to advanced radiolucency; no other clinically relevant radiolucency was observed.

Conclusion

Treatment with inlay total shoulder arthroplasty demonstrated meaningful functional improvement, excellent pain relief, and patient satisfaction in patients with advanced shoulder arthritis and various glenoid stages. Our initial evidence provides further support for this new option in primary shoulder replacement.


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