ShoulderAnatomic total shoulder arthroplasty with an inlay glenoid component: clinical outcomes and return to activity
Section snippets
Patient selection
A retrospective review was conducted in a consecutive series of patients undergoing anatomic TSA with an inlay glenoid component and a stemless ovoid humeral head component (Arthrosurface, Franklin, MA, USA), for a diagnosis of primary or post-traumatic glenohumeral osteoarthritis, performed by a single surgeon between February 1, 2014, and March 1, 2017. Prior to TSA, patients underwent nonoperative management including modification of activity and oral anti-inflammatories in all cases. In
Patient demographic characteristics
During the study period, TSA with an inlay glenoid component was performed in 27 shoulders in 24 patients and, in all cases, with a stemless humeral component. All 27 shoulders were available for 2-year follow-up (average, 40.4 ± 12.1 months; range, 24-60 months). Patients' average age was 52.1 ± 6.0 years (range, 42-63 years), 92.6% of shoulders (25 of 27) were in male patients, and worker's compensation claimants comprised 11.1% (3 of 27) (Table I). The preoperative diagnosis was glenohumeral
Discussion
Anatomic TSA with an inlay glenoid and stemless ovoid humeral head in a young, active population resulted in improved clinical outcomes at an average of 40.4 months' follow-up. The majority of patients were satisfied with their shoulder; however, only 55% returned to sporting activity at the same level or a higher level. There were no reoperations, and annual postoperative radiographs revealed no inlay component loosening.
Treatment of the young, active patient with advanced glenohumeral
Conclusion
Anatomic TSA with an inlay glenoid and a stemless ovoid humeral head in a young, active population resulted in excellent range of motion, improved clinical outcomes, no reoperations or radiographic loosening, and a high rate of return to occupational and sporting activity at shorter-term follow-up.
Disclaimer
This study received departmental funding.
Brian R. Waterman is an American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America board or committee member; is an editorial board member of the American Journal of Orthopedics and Arthroscopy; receives publishing royalties and financial or material support from Arthroscopy and Elsevier; and is a paid presenter or speaker for Genzyme.
Gregory P. Nicholson receives royalties
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This study was approved by the Rush University Medical Center Institutional Review Board on January 23, 2017, under ORA no. 16121601-IRB01.