Are there differences between stemless and conventional stemmed shoulder prostheses in the treatment of glenohumeral osteoarthritis?

BMC Musculoskeletal Disorders

Felix Zeifang¹  David Spranz¹  Matthias Bülhoff¹  Matthias C. Klotz¹  Sarah Lauer¹  Michael W. Maier¹ 

[1] Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstraße 200a, Heidelberg, D-69118, Germany

关键词: Angle reproduction test;    Joint position sense;    Proprioception;    Constant score;    Osteoarthritis;    Stemless shoulder prosthesis;   

Others  :  1232901
DOI  :  10.1186/s12891-015-0723-y

 received in 2014-11-22, accepted in 2015-09-16,  发布年份 2015

【 摘 要 】

Background

Conventional stemmed anatomical shoulder prostheses are widely used in the treatment of glenohumeral osteoarthritis. The stemless shoulder prosthesis, in contrast, is a new concept, and fewer outcome studies are available. Therefore, the purpose of the study was to investigate the early functional outcome and postoperative proprioception of a stemless prosthesis in comparison with a standard stemmed anatomic shoulder prosthesis.

Methods

Twelve patients (mean age 68.3 years [SD ± 5.4]; 5 female, 7 male) with primary glenohumeral osteoarthritis of the shoulder were enrolled, who underwent total shoulder arthroplasty (TSA) with a stemless total shoulder prosthesis, Total Evolution Shoulder System (TESS®; Biomed, France). The control group consisted of twelve (age and gender matched) patients (mean age 67.8 years; [SD ± 7.1]; 9 female, 3 male), getting a TSA with a standard anatomic stemmed prosthesis, Aequalis® Shoulder (Tournier, Lyon, France). Patients were examined the day before and six months after surgery. The pre- and postoperative Constant Score (CS) was evaluated and proprioception was measured in a 3D video motion analysis study using an active angle-reproduction (AAR) test.

Results

Comparing the postoperative CS, there was no significant difference between the groups treated with the TESS® prosthesis (48.0 ± 13.8 points) and the Aequalis® prosthesis (49.3 ± 8.6 points; p = 0.792). There was no significant difference in postoperative proprioception between the TESS® group (7.2° [SD ± 2.8]) and the Aequalis® group(8.7° [SD ± 2.7]; p = 0.196), either. Comparison of in the results of CS and AAR test pre- and postoperatively showed no significant differences between the groups.

Discussion

In patients with glenohumeral osteoarthritis, treated with TSA, the functional and the proprioceptive outcome is comparable between a stemless and a standard stemmed anatomic shoulder prosthesis at early followup.

Conclusion

Further follow-up is necessary regarding the long-term performance of this prosthesis.

Trial registration

Current Controlled Trials DRKS 00007528. Registered 17 November 2014

【 授权许可】

   
2015 Maier et al.

【 图 表 】

Fig. 1.

Fig. 2.

Fig. 3.

Fig. 4.

【 参考文献 】

• [1]Berth A, Pap G. Stemless shoulder prosthesis versus conventional anatomic shoulder prosthesis in patients with osteoarthritis: A comparison of the functional outcome after a minimum of two years follow-up. J Orthop Traumatol. 2013; 14(1):31-7.
• [2]Bryant D, Litchfield R, Sandow M, Gartsman GM, Guyatt G, Kirkley A. A comparison of pain, strength, range of motion, and functional outcomes after hemiarthroplasty and total shoulder arthroplasty in patients with osteoarthritis of the shoulder. A systematic review and meta-analysis. J Bone Joint Surg Am. 2005; 87:1947-1956.
• [3]Lo IK, Litchfield RB, Griffin S, Faber K, Patterson SD, Kirkley A. Quality-of-life outcome following hemiarthroplasty or total shoulder arthroplasty in patients with osteoarthritis. A prospective, randomized trial. J Bone Joint Surg Am. 2005; 87:2178-2185.
• [4]Heers G, Grifka J, An KN. [Biomechanical considerations on shoulder joint prosthesis implantation]. Orthopade. 2001; 30:346-353.
• [5]Boileau P, Walch G. The three-dimensional geometry of the proximal humerus. Implications for surgical technique and prosthetic design. J Bone Joint Surg Br. 1997; 79:857-865.
• [6]Kadum B, Mafi N, Norberg S, Sayed-Noor AS. Results of the Total Evolutive Shoulder System (TESS): a single-centre study of 56 consecutive patients. Arch Orthop Trauma Surg. 2011; 131:1623-1629.
• [7]Huguet D, DeClercq G, Rio B, Teissier J, Zipoli B, Group T. Results of a new stemless shoulder prosthesis: radiologic proof of maintained fixation and stability after a minimum of three years' follow-up. J Shoulder Elbow Surg. 2010; 19:847-852.
• [8]Razmjou H, Holtby R, Christakis M, Axelrod T, Richards R. Impact of prosthetic design on clinical and radiologic outcomes of total shoulder arthroplasty: a prospective study. J Shoulder Elbow Surg. 2013; 22(2):206-14.
• [9]Blasier RB, Carpenter JE, Huston LJ. Shoulder proprioception. Effect of joint laxity, joint position, and direction of motion. Orthop Rev. 1994; 23:45-50.
• [10]Liu A, Xue X, Chen Y, Bi F, Yan S. The external rotation immobilisation does not reduce recurrence rates or improve quality of life after primary anterior shoulder dislocation: a systematic review and meta-analysis. Injury. 2014; 45:1842-1847.
• [11]Vavken P, Sadoghi P, Quidde J, Lucas R, Delaney R, Mueller AM et al.. Immobilization in internal or external rotation does not change recurrence rates after traumatic anterior shoulder dislocation. J Shoulder Elbow Surg. 2014; 23:13-19.
• [12]Kasten P, Maier M, Rettig O, Raiss P, Wolf S, Loew M. Proprioception in total, hemi- and reverse shoulder arthroplasty in 3D motion analyses: a prospective study. Int Orthop. 2009; 33:1641-1647.
• [13]Maier MW, Niklasch M, Dreher T, Wolf SI, Zeifang F, Loew M et al.. Proprioception 3 years after shoulder arthroplasty in 3D motion analysis: a prospective study. Arch Orthop Trauma Surg. 2012; 132(7):1003-10.
• [14]Cuomo F, Birdzell MG, Zuckerman JD. The effect of degenerative arthritis and prosthetic arthroplasty on shoulder proprioception. J Shoulder Elbow Surg. 2005; 14:345-348.
• [15]Neer CS. Articular replacement for the humeral head. J Bone Joint Surg Am. 1955; 37-A:215-228.
• [16]Constant CR. An evaluation of the Constant-Murley shoulder assessment. J Bone Joint Surg Br. 1997; 79:695-696.
• [17]Constant CR, Murley AH: A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 1987:160–164
• [18]Kasten P, Maier M, Wendy P, Rettig O, Raiss P, Wolf S et al.. Can shoulder arthroplasty restore the range of motion in activities of daily living? A prospective 3D video motion analysis study. J Shoulder Elbow Surg. 2010; 19:59-65.
• [19]Rettig O, Fradet L, Kasten P, Raiss P, Wolf SI. A new kinematic model of the upper extremity based on functional joint parameter determination for shoulder and elbow. Gait Posture. 2009; 30:469-476.
• [20]Wu G, van der Helm FC, Veeger HE, Makhsous M, Van Roy P, Anglin C et al.. ISB recommendation on definitions of joint coordinate systems of various joints for the reporting of human joint motion--Part II: shoulder, elbow, wrist and hand. J Biomech. 2005; 38:981-992.
• [21]Rokito AS, Birdzell MG, Cuomo F, Di Paola MJ, Zuckerman JD. Recovery of shoulder strength and proprioception after open surgery for recurrent anterior instability: a comparison of two surgical techniques. J Shoulder Elbow Surg. 2010; 19:564-569.
• [22]Ingemarsson AH, Frandin K, Hellstrom K, Rundgren A. Balance function and fall-related efficacy in patients with newly operated hip fracture. Clin Rehabil. 2000; 14:497-505.
• [23]Boileau P, Sinnerton RJ, Chuinard C, Walch G. Arthroplasty of the shoulder. J Bone Joint Surg Br. 2006; 88:562-575.
• [24]Irlenbusch U, Berth A, Blatter G, Zenz P. Variability of medial and posterior offset in patients with fourth-generation stemmed shoulder arthroplasty. Int Orthop. 2012; 36:587-593.