Patients with primary glenohumeral arthritis and either concentric or non-concentric glenoids experienced excellent clinical benefits when treated with non-spherical shoulder arthroplasty with an inlay glenoid replacement, according to published results.
In a retrospective case series, Anthony Miniaci, MD, and colleagues collected the Penn Shoulder Score, VAS score for pain, range of motion, radiographic analysis and complications among 29 patients with primary glenohumeral arthritis, intact rotator cuffs and no prior open shoulder surgeries treated with a combination of non-spherical humeral head resurfacing and inlay glenoid replacements (HemiCap OVO/Inlay Glenoid Total Shoulder System; Arthrosurface).
Results showed no statistically significant differences in Penn Shoulder Score domains, including pain, function, satisfaction and total score; forward flexion, external rotation and VAS score for pain between concentric (n=7) and non-concentric (n=24) glenoids. Researchers found a mean Penn Shoulder Score of 25.3 for pain, 52.7 for function and 8.4 for satisfaction and a total score of 87. Patients had a mean forward flexion of 167.3°, external rotation of 56.6° and VAS for pain of 0.9, according to results. Researchers noted no signs of periprosthetic fracture, component loosening, osteolysis or hardware failure, and no patients required revision or 90-day rehospitalization.
Based on these results, Miniaci said non-spherical shoulder arthroplasty with inlay glenoid replacement may be a less invasive solution for treatment of glenohumeral arthritis in patients with an intact rotator cuff and no prior open shoulder surgeries.
“What we have done is we have changed the biomechanics to make it a more favorable situation so that these patients not only have better function, but ... the biomechanics would suggest that, because of the stress reduction on both sides of the joint, this type of construct would be better for ... younger active patients who have arthritis in their shoulder,” Miniaci told Healio.com/Orthopedics. – by Casey Tingle
Disclosure: Miniaci reports consulting fees and royalties from Arthrosurface.