Background
Aims of the study
Materials and methods
Database search
Study selection
Statistical analysis
Before 2012 | After 2012 | ||
---|---|---|---|
Eccentric reaming | Mean follow-up (months) | 47.7 | 55.4 |
SD (months) | 27.0 | 23.1 | |
Test statistics | −0.44 | ||
p | 0.69 | ||
H0 | H0 cannot be rejected, mean follow-up times are equal pre-2012 and post-2012 | ||
Posterior glenoid augmentation | Mean follow-up (months) | * | 32.8 |
SD (months) | * | 7.8 | |
Test statistics | NA* | ||
p | NA* | ||
H0 | NA* | ||
Bone grafting | Mean follow-up (months) | 70.3 | 65.3 |
SD (months) | 9.5 | 25.8 | |
Test statistics | 0.30 | ||
p | 0.78 | ||
H0 | H0 cannot be rejected, mean follow-up times are equal pre-2012 and post-2012 |
Results
Surgical technique | Mean age | Study level | Date of surgeries | Number of cases (total) | Follow-up (months) | Clinical outcomes (Neer rating, Constant Score) | Radiological outcomes | Complications | With revision (n) |
---|---|---|---|---|---|---|---|---|---|
Eccentric reaming | |||||||||
Habermeyer et al. 2007 [12] | 67.6 | II | NR | 24 (77) | 24 | Constant 90 (47.6) | No radiolucency | Loosening with breakage of the screw: n = 1 Bone block resorption: n = 1 | 2 |
Walch et al. 2012** [38] | 68 | IV | 1991–2007 | 85 | 77 | Neer rating: 61 very satisfied 15 uncertain 16 disappointed Constant 68.8 (32.4) | RLL score possible loosening in 7, 19 loosening, 11 with migration | Revision: n = 15: (loosening: n = 6; instability: n = 5; soft tissue problem: n = 4) | 13 |
Gerber et al. 2009 [11] | 60 | IV | 1998–2003 | 5(23) | 42 | Constant 78 (39), SSV 89 (40) | NR | NR | NR |
Bone grafting | |||||||||
Steinmann et al. 2000* (type of deformity) [35] | 56 | III | 1976–1992 | 28 | 63.6 | Neer rating: 13 excellent 10 satisfactory 5 unsatisfactory | Incomplete lucency: n = 11, Complete lucency: n = 4 | Glenoid loosening: n = 2 (symptomatic) Re-operation for instability: n = 2 Persistent pain: n = 1 | 2 |
Walch et al. 2012** [38] | 68 | IV | 1991–2007 | 7 | 77 | Results, see ** above; they did not distinguish between the two techniques | Results, see ** above; they did not distinguish between the two techniques | Collapse and migration -decline: n = 2 Posterior dislocation: n = 3 | 2 |
PAG | |||||||||
Rice et al. 2008 [28] | 66 | IV | 1995–1999 | 14 | 60 | Neer rating: 5 excellent 7 satisfactory 2 unsatisfactory | Grade I lucency: n = 7; grade V lucency: n = 1 | Anterior instability: n = 1 | 0 |
Surgical technique | Mean age | Study level | Date of surgeries | Number of cases | Follow-up (months) | Clinical outcomes (rating scores) | Radiological outcomes (lucent lines) | Complications | With revision (prothesis related; n) |
---|---|---|---|---|---|---|---|---|---|
Eccentric reaming | |||||||||
Orvets et al. 2018 [23] | 64 | IV | 2007–2014 | 59 | 50 | ASES 84 (35.4) | Lazarus I: n = 13 | PS cuff tear: n = 1 | 0 |
Lazarus II: n = 2 | |||||||||
Lazarus III: n = 5 | |||||||||
Chin et al. 2015 [8] | 68.7 | III | 2004–2011 | 48 | 60 | NR | NR | SC failure: n = 1 PJI: n = 2n= Loosening: n = 1 | 1 |
Simon et al. 2022 [34] | 68.1 | IV | NR | 20 | 48 | ASES 94.3 (41.6), Constant 77.9 (30.3) | Lazarus I: n = 11 Lazarus II: n = 1 | AC joint pain: n = 7 Chronic pain: n = 3 Loosening: n = 1 | 1 |
– | |||||||||
Sheth et al. 2020 [33] | 65.9 | III | 2004–2016 | 111 | 40 | ASES 88.8 (39.8), Constant 78.4 (26.8) | Lazarus I: n = 32 | Posterior dislocation: n = 3 SC failure: n = 2 PJI: n = 2 | 4 |
Lazarus II: n = 5 | |||||||||
Lazarus III: n = 3 | |||||||||
Lazarus V: n = 1 | |||||||||
Schnetzke et al. 2019 [32] | 70 | IV | 2012–2014 | 13 | 37 | Constant 75 (36) | NR | PJI: n = 1 Radialis neurapraxia: n = 1 Instability: n = 1 | 1 |
Magosch et al. 2021 [21] | 67.3 | IV | 2011–2016 | 14 | 49 | Constant 77.9 (41.2) | Incomplete radiolucent line: n = 1 | RC failure: n = 1 Instability: n = 1 Infection: n = 1 | 1 |
Hinse et al. 2023 [14] | 65.1 | IV | 2002–2013 | 32 | 110 | Constant 78 (42) | Lazarus 0: n = 8 Lazarus I: n = 10 Lazarus II: n = 6 Lazarus III: n = 2 Lazarus IV: n = 1* Lazarus V: n = 5* | Instability: n = 3 Infection: n = 1 SC failure: n = 1 | 3 |
Chamberlain et al. 2020 [7] | 61.7 | IV | 2007–2014 | 20 | 49 | ASES 86.2 (32.7) | Lazarus I: n = 5 Lazarus II: n = 1 | No complications | 0 |
Bone grafting | |||||||||
Nicholson et al. 2017 [22] | 61.4 | IV | 2004–2014 | 15 | 48 | ASES 90 (39), SST 10 (4) | Lucent line at the peg: n = 1 | Broken screws: n = 3 | 0 |
Klika et al. 2014 [19] | 66 | IV | 1976–2008 | 12 | 95 | Neer rating 8 excellent, 2 satisfactory, 2 unsatisfactory | Shoulders with radiolucent lines: n = 10 | Loosening: n = 2 | 2 |
Sabesan et al. 2013 [29] | 55.8 | IV | 2002–2009 | 9 | 53 | Penn 79.4 (38.7) | NR | Broken screws: n = 2 | 0 |
Augmented glenoid implants | |||||||||
Garrigues et al. 2022 (Aug-poly) [10] | 68 | IV | NR | 43 | 35 | Constant Score 76.9 (41.8), ASES 86.7 (49.8) | Incomplete radiolucent lines: n = 3, Complete (pegged): n = 2 | PJI: n = 1 SC failure: n = 2 Loosening: n = 1 | 1 |
Wright et al. 2015 (Aug-poly) [40] | 65.8 | II | NR | 24 | 24 | Constant Score 75.6 (38.6), ASES 91.5 (42.6), SST 11 (5), UCLA 32.1 (15.2) | Radiolucent lines: n = 12 Loosening: n = 1 | 0 | 0 |
Favorito et al. 2016 (Aug-poly) [9] | 62 | IV | 2011–2013 | 20 | 36 | WOOS Score 85.7 (42.7) | Lazarus I: n = 8 Lazarus II: n = 1 | Anterior instability: n = 1 Posterior instability: n = 1 | 2 |
Ianotti et al. (Aug-poly) 2021 [16] | 61.8 | II | NR | 29 | 28 | Penn 97.4 (30.6) | CPO not significant: n = 3 CPO I: n = 6 | Axillary nerve palsy: n = 1 Musculocutaneous nerve injury, complete return: n = 1 Revision of LTO: n = 1 | 1 |
Ho et al. 2018 (Aug-poly) [15] | 65 | IV | 2010–15 | 46 | 27 | Penn 94 (30) | Lazarus I: 6 Lazarus II–III: n = 40 | NR | 0 |
Stephens et al. 2017 (Aug-poly) [36] | 66 | IV | NR | 19 | 35 | ASES 91 (39) | Lazarus I: n = 4 Lazarus II: n = 1 | NR | 0 |
Sandow et al. 2020 (TMGA) [31] | 64.1 | IV | 2012–2019 | 28 | 48 | Oxford 44 (21), ASES 92 (24) | Minor lucency around the peg: n = 4 | PJI: n = 1 | 0 |
Sandow et al. 2016 (TMGA) [30] | 60–79* | IV | 2012 | 4 | 24 | Oxford 44 (20.10) | No lucency or loosening | NR | 0 |
Priddy et al. 2021 (All-poly) [25] | 64.1 | III | 2010–2015 | 37 | 38 | Constant 82.7 (47.6) ASES 86.8 (45.3) | Lazarus I: n = 7 Lazarus II: n = 3 Lazarus III: n = 2 Lazarus IV: n = 2 Lazarus V: n = 6 | PJI: n = 1 Loosening: n = 1 | – |
Complications following operations | Before 2012— total | Complications | % | Mean follow-up (months) | After 2012—total | Complications | % | Mean follow-up (months) |
---|---|---|---|---|---|---|---|---|
Eccentric reaming | 114 | 15 | 11.41 | 47.67 | 332 | 11 | 3.28 | 55.38 |
Bone grafting | 43 | 4 | 9.30 | 70.3 | 36 | 2 | 5.55 | 65.33 |
Posterior augmented glenoids | 14 | 0 | 0.00 | 60 | 240 | 5 | 2.08 | 32.78 |
Total | 171 | 19 | 11.11 | 59.32 | 608 | 18 | 2.96 | 51.14 |
Outcomes
Discussion
Eccentric Reaming
Bone grafting
Posterior glenoid components
Revision and complication rates
Limitations
Practical conclusion
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The outcomes of anatomic total shoulder arthroplasty for osteoarthritis with B2 glenoids have shown significantly lower prothesis-related complication rates since 2012.
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Eccentric reaming and posterior augmented glenoid components may now be considered as reliable surgical solutions in managing many patients with a B2 glenoid and an intact rotator cuff.
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Using modern preoperative planning techniques gives surgeons a better understanding of the glenoid morphology and enables more accurate placement of components, hopefully leading to longer survival.