Article

Arthroplasty for glenohumeral arthropathies have specific
complications and the final results are sometimes more dependent upon the type of
shoulder arthroplasty than the initial etiology. The aim of our study was to
evaluate the rate of complications and the functional improvement with different
types of shoulder arthroplasties after a minimum follow-up of 8years. This was a multicenter retrospective study of 198 shoulders
including 85 primary osteoarthritis of the shoulder, 76 cuff tear arthropathies,
19 avascular necrosis and 18 rheumatoid arthritis. Arthroplasties included 104
anatomic total shoulder arthroplasties (TSA), 77 reverse arthroplasties and 17
hemiarthroplasties. Ten patients had their arthroplasty revised, and 134 patients
with TSA were able to be present at the final follow-up or provide information on
their case. Function was evaluated by the Constant-Murley score and loosening by
standard radiographs. RESULTS: In the group with primary osteoarthritis of the
shoulder, there were eight complications (11%) including six (8.3%) requiring
implant revision. In the group of rotator cuff arthropathies, there were nine
(14.7%) complications including four (6.5%) requiring implant revision. In the
group with rheumatoid arthritis, there was one complication, and no surgical
revision was necessary. There were no complications in the group with avascular
necrosis. Glenoid migration occurred in 28.5% of anatomic TSA, and 3.4% of
reverse arthroplasties. This difference was significant (P<0.001). The
Constant-Murley score was significantly improved in all etiologies. CONCLUSIONS:
Glenohumeral arthropathies can be successfully treated by arthroplasty. Anatomic
TSA was shown to be associated with a high risk of glenoid loosening at
radiographic follow-up, which makes us hesitate to use the cemented polyethylene
implant, especially in young patients. LEVEL OF EVIDENCE: IV - Retrospective
study.
CI - Copyright (c) 2012 Elsevier Masson SAS. All rights reserved.

Langue : FRANCAIS