Mid-term results of Eclipse total shoulder arthroplasty
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| Title: | Mid-term results of Eclipse total shoulder arthroplasty |
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| Authors: | Timothy J. Batten, Sian Gallacher, Jonathan P. Evans, Richard J. Harding, Jeffrey Kitson, Christopher D. Smith, William J. Thomas |
| Source: | The Bone & Joint Journal. :83-90 |
| Publisher Information: | British Editorial Society of Bone & Joint Surgery, 2022. |
| Publication Year: | 2022 |
| Subject Terms: | Range of Motion, Oxford Shoulder Score, Adult, Male, Shoulder, Replacement, Postoperative Complications/diagnostic imaging, Radiolucent lines, Stemless prosthesis, radiolucencies, Outcomes, Survivorship, radiological outcomes, Prosthesis Design, Arthroplasty, glenoid, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Osteoarthritis, 80 and over, Shoulder replacement, Humans, Shoulder/*methods, Range of Motion, Articular, Osteoarthritis/diagnostic imaging/*surgery, Aged, anatomical total shoulder arthroplasty, Aged, 80 and over, Oss, Shoulder Prosthesis, Recovery of Function, Middle Aged, rotator cuff, Prosthesis Failure, humeral components, total shoulder arthroplasty, Arthroplasty, Replacement, Shoulder, Female, Radiographs, Articular |
| Description: | Aims The use and variety of stemless humeral components in anatomical total shoulder arthroplasty (TSA) have proliferated since their advent in 2004. Early outcomes are reassuring but independent mid-term results are scarce. This independent study reports a consecutive series of 143 Eclipse stemless shoulder prostheses with a minimum five-year (5 to 10) follow-up. Methods Outcomes of 143 procedures undertaken for all indications in 131 patients were reviewed, with subset analysis of those for osteoarthritis (OA) (n = 99). The primary outcome was the Oxford Shoulder Score (OSS) at a minimum of five years. Secondary outcomes were ranges of motion and radiological analysis of humeral radiolucency, rotator cuff failure, and glenoid loosening. Results Mean OSS at mean follow-up of 6.67 years (5.0 to 10.74) was 40.12 (9 to 48), with no statistically significant difference between those implanted for a non-OA indication and those for OA (p = 0.056) or time-dependent deterioration between two years and five years (p = 0.206). Ranges of motion significantly improved compared with preoperative findings and were maintained between two and five years with a mean external rotation of 38° (SD 18.1, 0 to 100) and forward elevation of 152° (SD 29.9, 90 to 180). Of those components with radiographs suitable for analysis (n = 83), 23 (28%) were found to have a least one humeral radiolucent line, which were predominantly incomplete, less than 2 mm, and in a single anatomical zone. No humeral components were loose. A radiolucent line was present around 22 (15%) of glenoid components, and 15 (10%) of components had failed. Rotator cuff failure was found in 21 (15%) components. The mean time to either glenoid or rotator cuff failure was greater than three years following implantation. Survivorship was 96.4% (95% CI 91.6 to 98.5, number at risk 128) at five years, and 94.3% (95% CI 88.2 to 97.3, number at risk 76) at seven years, both of which compare favourably with best results taken from available registries. Conclusion Functional and radiological outcomes of the Eclipse stemless TSA are excellent, with no loose humeral components at minimum five-year follow-up. The presence of radiolucent lines is of interest and requires long-term observation but does not impact on the clinical results. Of the eight revisions required, this was predominantly for glenoid and rotator cuff failure. Cite this article: Bone Joint J 2022;104-B(1):83–90. |
| Document Type: | Article |
| Language: | English |
| ISSN: | 2049-4408 2049-4394 |
| DOI: | 10.1302/0301-620x.104b1.bjj-2021-0869.r2 |
| Access URL: | https://pubmed.ncbi.nlm.nih.gov/34969289 |
| Rights: | URL: https://online.boneandjoint.org.uk/TDM |
| Accession Number: | edsair.doi.dedup.....f910ff0debf4c1c89eb3021a8ffb9a07 |
| Database: | OpenAIRE |
Nájsť tento článok vo Web of Science | Abstract: | Aims The use and variety of stemless humeral components in anatomical total shoulder arthroplasty (TSA) have proliferated since their advent in 2004. Early outcomes are reassuring but independent mid-term results are scarce. This independent study reports a consecutive series of 143 Eclipse stemless shoulder prostheses with a minimum five-year (5 to 10) follow-up. Methods Outcomes of 143 procedures undertaken for all indications in 131 patients were reviewed, with subset analysis of those for osteoarthritis (OA) (n = 99). The primary outcome was the Oxford Shoulder Score (OSS) at a minimum of five years. Secondary outcomes were ranges of motion and radiological analysis of humeral radiolucency, rotator cuff failure, and glenoid loosening. Results Mean OSS at mean follow-up of 6.67 years (5.0 to 10.74) was 40.12 (9 to 48), with no statistically significant difference between those implanted for a non-OA indication and those for OA (p = 0.056) or time-dependent deterioration between two years and five years (p = 0.206). Ranges of motion significantly improved compared with preoperative findings and were maintained between two and five years with a mean external rotation of 38° (SD 18.1, 0 to 100) and forward elevation of 152° (SD 29.9, 90 to 180). Of those components with radiographs suitable for analysis (n = 83), 23 (28%) were found to have a least one humeral radiolucent line, which were predominantly incomplete, less than 2 mm, and in a single anatomical zone. No humeral components were loose. A radiolucent line was present around 22 (15%) of glenoid components, and 15 (10%) of components had failed. Rotator cuff failure was found in 21 (15%) components. The mean time to either glenoid or rotator cuff failure was greater than three years following implantation. Survivorship was 96.4% (95% CI 91.6 to 98.5, number at risk 128) at five years, and 94.3% (95% CI 88.2 to 97.3, number at risk 76) at seven years, both of which compare favourably with best results taken from available registries. Conclusion Functional and radiological outcomes of the Eclipse stemless TSA are excellent, with no loose humeral components at minimum five-year follow-up. The presence of radiolucent lines is of interest and requires long-term observation but does not impact on the clinical results. Of the eight revisions required, this was predominantly for glenoid and rotator cuff failure. Cite this article: Bone Joint J 2022;104-B(1):83–90. |
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| ISSN: | 20494408 20494394 |
| DOI: | 10.1302/0301-620x.104b1.bjj-2021-0869.r2 |