Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2019

Open Access 01-12-2019 | Arthritis | Research article

Do the radiological changes seen at mid term follow up of stemless shoulder prosthesis affect outcome?

Authors: Mohamed Moursy, Milan Niks, Aditya S. Kadavkolan, Lars J. Lehmann

Published in: BMC Musculoskeletal Disorders | Issue 1/2019

Login to get access

Abstract

Background

The Eclipse® (Eclipse® is a trademark of Arthrex, Naples, Florida) stemless shoulder prosthesis offers the surgeon the advantage of bone stock preservation and at the same time avoids the drawbacks of a resurfacing arthroplasty. Previous studies have shown radiographic changes on serial follow up of the Eclipse prosthesis. This study attempts to assess the significance of these radiographic changes and effect of cuff related pathology on the mid-term outcome of the Eclipse prosthesis.

Methods

Between July 2005 and October 2008, 29 shoulders underwent shoulder arthroplasty with the Eclipse prosthesis; 23 shoulders, (seven women and 16 men) were available for the final follow up. The range of motion, Constant Score; age adjusted Constant Score, Subjective Shoulder Value and radiographs were assessed at serial follow-ups.

Results

Significant improvements were seen in the Constant Score (78.9 ±20.1) compared to pre-operative score (32.9 ±5.2); also forward elevation, abduction and external rotation improved to 142.9 ± 36.6 °, 135.2 ± 40.5 ° and 49.8 ± 21.9 ° at 72 months (p < 0.001). Radiolucent lines and localised osteopenia, did not statistically impact on the clinical outcome. Partial tears of the supraspinatus and subscapularis had a negative impact on the Subjective Shoulder Value (p < 0.05) Partial or complete tears of the subscapularis led to worse Constant Score on follow up (p < 0.05).

Conclusions

The presence of radiolucent lines or localised osteopenia does not influence the mid term clinical outcome. Pre -operative partial supraspinatus tears or tears of the subscapularis lead to an inferior outcome.
Appendix
Available only for authorised users
Footnotes
1
Fiberwire® is a trademark of Arthrex Inc. Naples, Florida
 
Literature
1.
go back to reference Wirth MA, Ondrla J, Southworth C, Kaar K, Anderson BC, Rockwood CA. Replicating proximal humeral articular geometry with a third-generation implant: a radiographic study in cadaveric shoulders. J Shoulder Elbow Surg. 2007;16(3):S111–S6.CrossRef Wirth MA, Ondrla J, Southworth C, Kaar K, Anderson BC, Rockwood CA. Replicating proximal humeral articular geometry with a third-generation implant: a radiographic study in cadaveric shoulders. J Shoulder Elbow Surg. 2007;16(3):S111–S6.CrossRef
2.
go back to reference Norris TR, Iannotti JP. Functional outcome after shoulder arthroplasty for primary osteoarthritis: a multicenter study. J Shoulder Elbow Surg. 2002;11(2):130–5.CrossRef Norris TR, Iannotti JP. Functional outcome after shoulder arthroplasty for primary osteoarthritis: a multicenter study. J Shoulder Elbow Surg. 2002;11(2):130–5.CrossRef
3.
go back to reference Pearl ML, Kurutz S. Geometric Analysis of Commonly Used Prosthetic Systems for Proximal Humeral Replacement*. J Bone Joint Surg. 1999;81(5):660–71.CrossRef Pearl ML, Kurutz S. Geometric Analysis of Commonly Used Prosthetic Systems for Proximal Humeral Replacement*. J Bone Joint Surg. 1999;81(5):660–71.CrossRef
4.
go back to reference Deshmukh AV, Koris M, Zurakowski D, Thornhill TS. Total shoulder arthroplasty: long-term survivorship, functional outcome, and quality of life. J Shoulder Elbow Surg. 2005;14(5):471–9.CrossRef Deshmukh AV, Koris M, Zurakowski D, Thornhill TS. Total shoulder arthroplasty: long-term survivorship, functional outcome, and quality of life. J Shoulder Elbow Surg. 2005;14(5):471–9.CrossRef
5.
go back to reference 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(6):847–52.CrossRef 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(6):847–52.CrossRef
6.
go back to reference Bohsali KI, Wirth MA, Rockwood CA. Complications of total shoulder arthroplasty. J Bone Joint Surg. 2006;88(10):2279–92.PubMed Bohsali KI, Wirth MA, Rockwood CA. Complications of total shoulder arthroplasty. J Bone Joint Surg. 2006;88(10):2279–92.PubMed
7.
go back to reference Copeland S. Cementless total shoulder replacement. Surgery of the shoulder St Louis: Mosby-Year Book. 1990;1990:289–93. Copeland S. Cementless total shoulder replacement. Surgery of the shoulder St Louis: Mosby-Year Book. 1990;1990:289–93.
8.
go back to reference Bunker T. Stemless shoulder replacement, the best of both worlds: a personal view. Shoulder Elbow. 2011;3(2):64–73.CrossRef Bunker T. Stemless shoulder replacement, the best of both worlds: a personal view. Shoulder Elbow. 2011;3(2):64–73.CrossRef
9.
go back to reference Mullett H, Levy O, Raj D, Even T, Abraham R, Copeland SA. Copeland surface replacement of the shoulder results of an hydroxyapatite-coated cementless implant in patients over 80 years of age. J Bone Joint Surg British Volume. 2007;89(11):1466–9.CrossRef Mullett H, Levy O, Raj D, Even T, Abraham R, Copeland SA. Copeland surface replacement of the shoulder results of an hydroxyapatite-coated cementless implant in patients over 80 years of age. J Bone Joint Surg British Volume. 2007;89(11):1466–9.CrossRef
10.
go back to reference Levy O, Funk L, Sforza G, Copeland SA. Copeland surface replacement arthroplasty of the shoulder in rheumatoid arthritis. J Bone Joint Surg. 2004;86(3):512–8.CrossRef Levy O, Funk L, Sforza G, Copeland SA. Copeland surface replacement arthroplasty of the shoulder in rheumatoid arthritis. J Bone Joint Surg. 2004;86(3):512–8.CrossRef
11.
go back to reference Harmer L, Throckmorton T, Sperling JW. Total shoulder arthroplasty: are the humeral components getting shorter? Curr Rev Musculoskelet Med. 2016;9(1):17–22.CrossRef Harmer L, Throckmorton T, Sperling JW. Total shoulder arthroplasty: are the humeral components getting shorter? Curr Rev Musculoskelet Med. 2016;9(1):17–22.CrossRef
12.
go back to reference Hawi N, Tauber M, Messina MJ, Habermeyer P, Martetschläger F. Anatomic stemless shoulder arthroplasty and related outcomes: a systematic review. BMC Musculoskelet Disord. 2016;17(1):376.CrossRef Hawi N, Tauber M, Messina MJ, Habermeyer P, Martetschläger F. Anatomic stemless shoulder arthroplasty and related outcomes: a systematic review. BMC Musculoskelet Disord. 2016;17(1):376.CrossRef
13.
go back to reference Habermeyer P, Lichtenberg S, Tauber M, Magosch P. Midterm results of stemless shoulder arthroplasty: a prospective study. J Shoulder Elbow Surg. 2015;24(9):1463–72.CrossRef Habermeyer P, Lichtenberg S, Tauber M, Magosch P. Midterm results of stemless shoulder arthroplasty: a prospective study. J Shoulder Elbow Surg. 2015;24(9):1463–72.CrossRef
14.
go back to reference Edwards TB, Boulahia A, Kempf J-F, Boileau P, Nemoz C, Walch G. The Influence of Rotator Cuff Disease on the Results of Shoulder Arthroplasty for Primary Osteoarthritis: Results of a Multicenter Study. Jbjs. 2002;84(12):2240–8.CrossRef Edwards TB, Boulahia A, Kempf J-F, Boileau P, Nemoz C, Walch G. The Influence of Rotator Cuff Disease on the Results of Shoulder Arthroplasty for Primary Osteoarthritis: Results of a Multicenter Study. Jbjs. 2002;84(12):2240–8.CrossRef
15.
go back to reference Iannotti JP, Norris TR. Influence of Preoperative Factors on Outcome of Shoulder Arthroplasty for Glenohumeral Osteoarthritis. Jbjs. 2003;85(2):251–8.CrossRef Iannotti JP, Norris TR. Influence of Preoperative Factors on Outcome of Shoulder Arthroplasty for Glenohumeral Osteoarthritis. Jbjs. 2003;85(2):251–8.CrossRef
16.
go back to reference Denard PJ, Raiss P, Gobezie R, Edwards TB, Lederman E. Stress shielding of the humerus in press-fit anatomic shoulder arthroplasty: review and recommendations for evaluation. J Shoulder Elbow Surg. 2018;27(6):1139–47.CrossRef Denard PJ, Raiss P, Gobezie R, Edwards TB, Lederman E. Stress shielding of the humerus in press-fit anatomic shoulder arthroplasty: review and recommendations for evaluation. J Shoulder Elbow Surg. 2018;27(6):1139–47.CrossRef
17.
go back to reference Walch G, Badet R, Boulahia A, Khoury A. Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplasty. 1999;14(6):756–60.CrossRef Walch G, Badet R, Boulahia A, Khoury A. Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplasty. 1999;14(6):756–60.CrossRef
18.
go back to reference Raiss P, Schmitt M, Bruckner T, Kasten P, Pape G, Loew M, et al. Results of cemented total shoulder replacement with a minimum follow-up of ten years. J Bone Joint Surg. 2012;94(23):e171.CrossRef Raiss P, Schmitt M, Bruckner T, Kasten P, Pape G, Loew M, et al. Results of cemented total shoulder replacement with a minimum follow-up of ten years. J Bone Joint Surg. 2012;94(23):e171.CrossRef
19.
go back to reference Levine WN, Fischer CR, Nguyen D, Flatow EL, Ahmad CS, Bigliani LU. Long-term follow-up of shoulder hemiarthroplasty for glenohumeral osteoarthritis. J Bone Joint Surg. 2012;94(22):e164.CrossRef Levine WN, Fischer CR, Nguyen D, Flatow EL, Ahmad CS, Bigliani LU. Long-term follow-up of shoulder hemiarthroplasty for glenohumeral osteoarthritis. J Bone Joint Surg. 2012;94(22):e164.CrossRef
20.
go back to reference Orfaly RM, Rockwood CA, Esenyel CZ, Wirth MA. A prospective functional outcome study of shoulder arthroplasty for osteoarthritis with an intact rotator cuff. J Shoulder Elbow Surg. 2003;12(3):214–21.CrossRef Orfaly RM, Rockwood CA, Esenyel CZ, Wirth MA. A prospective functional outcome study of shoulder arthroplasty for osteoarthritis with an intact rotator cuff. J Shoulder Elbow Surg. 2003;12(3):214–21.CrossRef
21.
go back to reference Sandow MJ, David H, Bentall SJ. Hemiarthroplasty vs total shoulder replacement for rotator cuff intact osteoarthritis: how do they fare after a decade? J Shoulder Elbow Surg. 2013;22(7):877–85.CrossRef Sandow MJ, David H, Bentall SJ. Hemiarthroplasty vs total shoulder replacement for rotator cuff intact osteoarthritis: how do they fare after a decade? J Shoulder Elbow Surg. 2013;22(7):877–85.CrossRef
22.
go back to reference Favard L, Katz D, Colmar M, Benkalfate T, Thomazeau H, Emily S. Total shoulder arthroplasty–Arthroplasty for glenohumeral arthropathies: Results and complications after a minimum follow-up of 8 years according to the type of arthroplasty and etiology. Orthop Traumatol Surg Res. 2012;98(4):S41–S7.CrossRef Favard L, Katz D, Colmar M, Benkalfate T, Thomazeau H, Emily S. Total shoulder arthroplasty–Arthroplasty for glenohumeral arthropathies: Results and complications after a minimum follow-up of 8 years according to the type of arthroplasty and etiology. Orthop Traumatol Surg Res. 2012;98(4):S41–S7.CrossRef
23.
go back to reference Denard PJ, Raiss P, Sowa B, Walch G. Mid-to long-term follow-up of total shoulder arthroplasty using a keeled glenoid in young adults with primary glenohumeral arthritis. J Shoulder Elbow Surg. 2013;22(7):894–900.CrossRef Denard PJ, Raiss P, Sowa B, Walch G. Mid-to long-term follow-up of total shoulder arthroplasty using a keeled glenoid in young adults with primary glenohumeral arthritis. J Shoulder Elbow Surg. 2013;22(7):894–900.CrossRef
24.
go back to reference Thomas SR, Wilson AJ, Chambler A, Harding I, Thomas M. Outcome of Copeland surface replacement shoulder arthroplasty. J Shoulder Elbow Surg. 2005;14(5):485–91.CrossRef Thomas SR, Wilson AJ, Chambler A, Harding I, Thomas M. Outcome of Copeland surface replacement shoulder arthroplasty. J Shoulder Elbow Surg. 2005;14(5):485–91.CrossRef
25.
go back to reference 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.CrossRef 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.CrossRef
26.
go back to reference Berth A, Pap G. Stemless shoulder prosthesis versus conventional anatomic shoulder prosthesis in patients with osteoarthritis. J Orthop Traumatol. 2013;14(1):31–7.CrossRef Berth A, Pap G. Stemless shoulder prosthesis versus conventional anatomic shoulder prosthesis in patients with osteoarthritis. J Orthop Traumatol. 2013;14(1):31–7.CrossRef
27.
go back to reference Gallacher S, Williams HLM, King A, Kitson J, Smith CD, Thomas WJ. Clinical and radiologic outcomes following total shoulder arthroplasty using Arthrex Eclipse stemless humeral component with minimum 2 years’ follow-up. J Shoulder Elbow Surg. 2018;27(12):2191–7.CrossRef Gallacher S, Williams HLM, King A, Kitson J, Smith CD, Thomas WJ. Clinical and radiologic outcomes following total shoulder arthroplasty using Arthrex Eclipse stemless humeral component with minimum 2 years’ follow-up. J Shoulder Elbow Surg. 2018;27(12):2191–7.CrossRef
28.
go back to reference 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(12):1623–9.CrossRef 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(12):1623–9.CrossRef
29.
go back to reference Churchill RS, Chuinard C, Wiater JM, Friedman R, Freehill M, Jacobson S, et al. Clinical and Radiographic Outcomes of the Simpliciti Canal-Sparing Shoulder Arthroplasty System: A Prospective Two-Year Multicenter Study. J Bone Joint Surg Am Vol. 2016;98(7):552–60.CrossRef Churchill RS, Chuinard C, Wiater JM, Friedman R, Freehill M, Jacobson S, et al. Clinical and Radiographic Outcomes of the Simpliciti Canal-Sparing Shoulder Arthroplasty System: A Prospective Two-Year Multicenter Study. J Bone Joint Surg Am Vol. 2016;98(7):552–60.CrossRef
30.
go back to reference Uschok S, Magosch P, Moe M, Lichtenberg S, Habermeyer P. Is the stemless humeral head replacement clinically and radiographically a secure equivalent to standard stem humeral head replacement in the long-term follow-up? A prospective randomized trial. J Shoulder Elbow Surg. 2017;26(2):225–32.CrossRef Uschok S, Magosch P, Moe M, Lichtenberg S, Habermeyer P. Is the stemless humeral head replacement clinically and radiographically a secure equivalent to standard stem humeral head replacement in the long-term follow-up? A prospective randomized trial. J Shoulder Elbow Surg. 2017;26(2):225–32.CrossRef
31.
go back to reference Hudek R, Werner B, Abdelkawi AF, Schmitt R, Gohlke F. Radiolucency in stemless shoulder arthroplasty is associated with an imaging phenomenons. J Orthop Res. 2016. Hudek R, Werner B, Abdelkawi AF, Schmitt R, Gohlke F. Radiolucency in stemless shoulder arthroplasty is associated with an imaging phenomenons. J Orthop Res. 2016.
32.
go back to reference Frost HM. Wolff’s Law and bone’s structural adaptations to mechanical usage: an overview for clinicians. Angle Orthodontist. 1994;64(3):175–88.PubMed Frost HM. Wolff’s Law and bone’s structural adaptations to mechanical usage: an overview for clinicians. Angle Orthodontist. 1994;64(3):175–88.PubMed
33.
go back to reference Schmidutz F, Agarwal Y, Müller PE, Gueorguiev B, Richards RG, Sprecher CM. Stress-shielding induced bone remodeling in cementless shoulder resurfacing arthroplasty: a finite element analysis and in vivo results. J Biomech. 2014;47(14):3509–16.CrossRef Schmidutz F, Agarwal Y, Müller PE, Gueorguiev B, Richards RG, Sprecher CM. Stress-shielding induced bone remodeling in cementless shoulder resurfacing arthroplasty: a finite element analysis and in vivo results. J Biomech. 2014;47(14):3509–16.CrossRef
Metadata
Title
Do the radiological changes seen at mid term follow up of stemless shoulder prosthesis affect outcome?
Authors
Mohamed Moursy
Milan Niks
Aditya S. Kadavkolan
Lars J. Lehmann
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Arthritis
Published in
BMC Musculoskeletal Disorders / Issue 1/2019
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-019-2870-z

Other articles of this Issue 1/2019

BMC Musculoskeletal Disorders 1/2019 Go to the issue