Mid- to long-term clinical and radiological results of anatomic total shoulder arthroplasty in patients with B2 glenoids

Abstract

Background: Eccentric biconcave (B2) glenoid erosion in primary glenohumeral arthritis is common. There are serious concerns regarding the longevity of fixation of cemented glenoids if anatomic total shoulder arthroplasties (aTSAs) are used in B2 glenoid. The purpose of this study is to analyze the mid- to long-term results of aTSA with B2 glenoids. Methods: This is a retrospective study of a single center experience. Thirty patients (32 shoulders) at an average of 9.2 years (range, 5.0-16.6, ±3.2) after primary TSA were evaluated. Clinical and radiographic outcomes were analyzed. Results: The mean preoperative intermediate glenoid version was −14° ± 7° (range, −2° to −29°) and the mean humeral subluxation according to the plane of the scapula was 67% ± 9% (range, 49%-87%). There was a significant improvement for all the postoperative clinical outcome parameters including the mean absolute and relative Constant Score, subjective shoulder value, active elevation, external rotation, abduction, internal rotation, pain scores, and strength (P < .001). The complication rate was 15.6% and the revision rate was 12.5% at a mean follow-up of 9.2 years (range, 5.0-16.6, ±3.2). The estimated survivorship without revision was 94% at 5 years and 85% at 10 years (12.1-14.7 years). The survival rate without advanced glenoid component loosening (defined as Lazarus grade ≥ 4 or modified Molé scores ≥ 6) was 91% at 5 years and 84% at 10 years (12.2-15.8 years). Conclusion: In this case series, aTSA with asymmetric reaming for the treatment of shoulder osteoarthritis with milder forms of B2 glenoid is a viable option with good to excellent clinical results and an 85% prosthetic survivorship at 10 years.

Keywords

• Mid-term results
• Anatomical total shoulder arthroplasty
• Glenohumeral osteoarthritis B2 glenoid
• Posterior glenoid deficiency
• Humeral subluxation