COMPARISON OF HUMERAL HEAD RESURFACING VERSUS STEMLESS HUMERAL COMPONENTS IN ANATOMIC TOTAL SHOULDER ARTHROPLASTY: A MULTICENTER INVESTIGATION WITH MINIMUM TWO YEAR FOLLOW UP

Document Type

Conference Proceeding

Publication Date

9-1-2023

Publication Title

JSES International

Abstract

Background: The purpose of this investigation was to compare minimum two-year outcomes of anatomic total shoulder arthroplasty (aTSA) performed with humeral head resurfacing (HHR) versus stemless implants. Methods: A retrospective review of a large multicenter database was conducted. All patients who underwent aTSA with either HHR or stemless implants with minimum two-year follow-up were evaluated. Range of motion (ROM) and patient reported outcomes (PROs) including Constant Score, Simple Shoulder test (SST), American Shoulder and Elbow score, University of California Los Angeles shoulder score, Shoulder Pain and Disability Index and Shoulder Arthroplasty Smart score were collected for all patients pre- and post-surgery. Radiographic data was collected to determine the presence of radiolucent lines as well as evaluation of implant sizing and anatomic shoulder restoration. Results: Overall, 127 patients were included with 49 receiving HHR and 78 stemless aTSA. The HHR group were significantly older (69.3±8.6 versus 64.3±8.7, P<0.01), had a lower BMI (27.7±4.3 versus 31.5±7.2, p<0.01) and a higher percentage were females (87.8% versus 35.9%, p<0.01) compared to the stemless group. Both groups demonstrated significant improvements in all PROs and ROM from pre- to post-surgery (p<0.05). At final follow-up the stemless group had significantly greater active abduction (148.5±27.7 versus 115.6±22.4, p<0.01), forward flexion (154.3±20.6 versus 140.6±15.3, p<0.01) and external rotation (52.14±14.9 versus 34.4±19.8, p=0.01). The stemless group exhibited better scores on the SST (10.4±2.0 versus 9.5±1.9, p=0.01), but no other PROs demonstrated significant difference. Radiographic evaluation of HHR patients demonstrated overstuffing, oversizing, and lucent lines around the glenoid component in 8.7%, 39.1%, and 13.0% of implants, respectively. Radiographic evaluation of stemless patients demonstrated radiolucent lines around humeral component and glenoid component in 4.2% and 18.8% of implants, respectively. One patient in the stemless aTSA group required a revision surgery for aseptic glenoid loosening, otherwise no other major complications were reported. Conclusions: Anatomic TSA performed both with stemless implants and HHR resulted in significant improvements in ROM and multiple PROs at minimum two year follow up with a low complication rate. The HHR group had significantly worse pre-operative ROM and PROs which lead to greater magnitudes of improvement at final follow up.

Volume

7

Issue

5

First Page

2082

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