Authors: Bradley Schoch JeanDavid Werthel Cathy Schleck John W Sperling Robert H Cofield
Publish Date: 2015/08/06
Volume: 39, Issue: 10, Pages: 2053-2060
Abstract
Modularity in total shoulder arthroplasty TSA has increased over the past 30 years Our institution previously showed shoulders treated with modular humeral head/stem arthroplasties had similar outcomes to monoblock designs Presently we aim to update clinical followup of 2nd generation TSAs and assess how increased modularity affects early outcomes and survivorship across three generations of implantsBetween 1997 and 2001 75 second generation modular TSA’s were performed for primary osteoarthritis Shoulders were followed for a minimum of 2 years or until reoperation mean 74 years Results were compared with first generation monoblock TSAs and third generation TSAs which offered multiple humeral head shape options to more precisely replicate patient anatomySecond generation TSAs continue to show significant improvements in pain elevation and external rotation 90 of shoulders were subjectively better at followup Survivorship was estimated to be 890 at 10 years All generations showed similar pain relief and improved range of motion and Neer ratings Survivorship among the 3 groups was similar at 5 years but was estimated to be higher in the 1st generation group at 7 years More glenoids were radiographically at risk in the 2nd and 3rd generation groups than in the 1st however this did not reach significanceWith extended midterm followup second generation anatomic TSA continues to provide improvements in pain and range of motion for primary OA Implant modularity can facilitate surgery but similar clinical outcomes can be expected regardless of modularityCofield royalties Smith/Nephew Sperling royalties Biomet The other authors have nothing to disclose that is relevant to this publication Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of researchAll procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards
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