Shoulder arthroplasty in patients aged fifty-five years or younger with osteoarthritis

被引:115
作者
Bartelt, Robert [1 ]
Sperling, John W. [1 ]
Schleck, Cathy D. [1 ]
Cofield, Robert H. [1 ]
机构
[1] Mayo Clin, Dept Orthoped Surg, Rochester, MN 55905 USA
关键词
Total shoulder arthroplasty; osteoarthritis; glenohumeral arthritis; young patient; PRIMARY GLENOHUMERAL OSTEOARTHRITIS; HUMERAL HEAD REPLACEMENT; NEER HEMIARTHROPLASTY; FOLLOW-UP; LESS; ARTHRITIS; OLD;
D O I
10.1016/j.jse.2010.05.006
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: The younger patient with glenohumeral arthritis presents a challenge because of concerns about activity and frequency of failure. The purpose of this study was to define the results, complications, and frequency of revision surgery in this group. Materials and methods: Between 1986 and 2005, 46 total shoulder arthroplasties and 20 hemiarthroplasties were performed in 63 patients who were aged 55 years or younger and had chronic shoulder pain due to glenohumeral osteoarthritis. All 63 patients had complete preoperative evaluation, operative records, and minimum 2-year follow-up (mean, 7.0 years) or follow-up until revision. Results: Nine shoulders underwent a revision operation. The implant survival rate was 92% (95% confidence interval, 77%-100%) at 10 years for total shoulder arthroplasty and 72% (95% confidence interval, 54%-97%) for hemiarthroplasty (Kaplan-Meier result). Patients who underwent total shoulder arthroplasty had less pain (P = .01), greater active elevation (P = .05), and higher satisfaction (P = .05) at final follow-up compared with those who underwent hemiarthroplasty. Complete radiographs were available for 47 arthroplasties with a minimum 2-year follow-up or follow-up until revision (mean, 6.6 years). More than minor glenoid periprosthetic lucency or a shift in component position was present in 10 of 34 total shoulder arthroplasties. Moderate to severe glenoid erosion was present in 6 of 13 hemiarthroplasties. Conclusions: This study indicates that there is intermediate- to long-term pain relief and improvement in motion with shoulder arthroplasty in young patients with osteoarthritis. These results favor total shoulder arthroplasty in terms of pain relief, motion, and implant survival. Level of evidence: Level IV, Case Series, Treatment Study. (C) 2011 Journal of Shoulder and Elbow Surgery Board of Trustees.
引用
收藏
页码:123 / 130
页数:8
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