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[Bipolar arthroplasty in rotator cuff arthropathy: 13 cases]
L D Duranthon1, B Augereau, H Thomazeau
1Service d'Orthopédie Traumatologie B, Hôpital Européen Georges Pompidou, 20, rue Leblanc, 75015 Paris.
Summary
Bipolar shoulder arthroplasty effectively relieves pain in patients with glenoid osteoarthritis but offers limited mobility improvements. Small cup sizes may yield better outcomes, suggesting careful consideration of implant size for optimal results.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Radiology
Context:
- Excentered osteoarthritis of the glenoid presents complex challenges in shoulder arthroplasty.
- Unrepairable rotator cuff tears are common in patients undergoing this procedure.
- Previous studies have explored various prosthetic designs and their outcomes.
Purpose:
- To report the outcomes of bipolar shoulder arthroplasty in 13 patients with excentered glenoid osteoarthritis.
- To evaluate clinical and radiographic results, including pain, function, range of motion, and implant stability.
- To compare outcomes associated with different prosthetic cup sizes.
Summary:
- Bipolar shoulder arthroplasty in 13 patients with excentered glenoid osteoarthritis showed significant pain relief (Constant score improved from 23 to 37).
- Functional outcomes were mixed, with improvements in passive external rotation but less satisfactory active motion.
- Radiographic assessment indicated a satisfactory deltoid lever arm, but three cases showed significant glenoid wear within two years.
- A trend favored smaller prosthetic cups (40/44mm) over larger ones (48/52mm) in terms of Constant score, Swanson score, and range of motion.
Impact:
- Findings suggest bipolar arthroplasty is effective for pain management in specific glenoid osteoarthritis cases.
- The study highlights the importance of prosthetic cup size selection, favoring smaller implants.
- Results contribute to understanding the biomechanical principles of shoulder arthroplasty, emphasizing deltoid lever arm maintenance without soft tissue overstretch.