Mid- to long-term follow-up of shoulder arthroplasty for primary glenohumeral osteoarthritis in patients aged 60 or under

• Published in: Journal of shoulder and elbow surgery Vol. 28; no. 9; pp. 1666 - 1673
• Main Authors: Neyton, Lionel, Kirsch, Jacob M., Collotte, Philippe, Collin, Philippe, Gossing, Louis, Chelli, Mikael, Walch, Gilles
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-09-2019
• Subjects: Adult; Arthroplasty, Replacement, Shoulder - adverse effects; Female; Follow-Up Studies; glenohumeral arthritis; hemiarthroplasty; Hemiarthroplasty - adverse effects; Humans; Male; Middle Aged; Osteoarthritis - complications; Osteoarthritis - physiopathology; Osteoarthritis - surgery; Pain, Postoperative - etiology; primary arthritis; Prosthesis Failure; Range of Motion, Articular; Reoperation; Retrospective Studies; Shoulder arthroplasty; Shoulder Joint - physiopathology; Shoulder Joint - surgery; Shoulder Pain - etiology; Time Factors; total shoulder arthroplasty; Treatment Outcome; Treatment Study; glenohumeral arthritis; Shoulder arthroplasty; primary arthritis; Retrospective Cohort Comparison; total shoulder arthroplasty; hemiarthroplasty; Level III
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2019.03.006

Shoulder arthroplasty in young patients with primary glenohumeral osteoarthritis is an area of continued controversy.
A retrospective multicenter study was performed for all patients aged 60 years or less undergoing either hemiarthroplasty (HA) or total shoulder arthroplasty (TSA) for primary glenohumeral osteoarthritis with a minimum of 24-month follow-up. Clinical and functional outcomes, complications, and need for revision surgery were analyzed. Survivorship analysis using revision arthroplasty as an endpoint was determined.
A total of 202 patients with a mean age of 55.3 years (range, 36-60 years) underwent TSA with a mean follow-up of 9 years (range, 2-24.7 years). Revision arthroplasty was performed in 33 (16.3%) shoulders, with glenoid failure associated with the revision in 29 shoulders (88%). TSA survivorship analysis demonstrated 95% free of revision at 5 years, 83% at 10 years, and 60% at 20-year follow-up. A total of 31 patients with a mean age of 52.5 years (range, 38-60 years) underwent HA with a mean follow-up of 8.7 years (range, 2-21.4 years). Revision arthroplasty was performed in 5 (16.1%) shoulders, with glenoid erosion as the cause for revision in 4 shoulders (80%). HA survivorship analysis demonstrated 84% free from revision at 5 years and 79% at the final follow-up. TSA resulted in a significantly better range of motion, pain, subjective shoulder value, and Constant score compared with HA.
In young patients with primary glenohumeral osteoarthritis, TSA resulted in significantly better functional and subjective outcomes with no significant difference in longitudinal survivorship compared with patients treated with HA.