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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Polyethylene insert exchange for wear after total shoulder arthroplasty
Emilie V Cheung1, John W Sperling, Robert H Cofield
1Department of Orthopedic Surgery, The Mayo Clinic, Rochester, MN 55905, USA.
Journal of Shoulder and Elbow Surgery
|May 29, 2007
Summary
Modular polyethylene exchange in total shoulder arthroplasty can be effective for wear, but outcomes are poor if rotator cuff tears or instability coexist. This challenges revision surgery success.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Revision Arthroplasty
Background:
- Limited clinical guidance exists for modular polyethylene exchange in total shoulder arthroplasty (TSA) due to wear.
- Polyethylene wear is a common indication for revision TSA, often associated with other complications.
Purpose of the Study:
- To evaluate the outcomes of modular polyethylene glenoid component exchange during revision total shoulder arthroplasty.
- To assess the effectiveness of polyethylene exchange in addressing glenoid wear in TSA.
Main Methods:
- Retrospective review of 12 shoulders (11 patients) undergoing revision TSA with polyethylene glenoid component exchange.
- Analysis of patient demographics, reasons for revision, and clinical outcomes including pain, range of motion, and satisfaction.
Main Results:
- The primary indication was polyethylene wear-through or displacement; rotator cuff tears and instability frequently coexisted.
- Postoperative pain improved (mean 4.5 to 2.6), and external rotation improved (mean 51 to 64 degrees).
- Forward elevation slightly decreased (93 to 89 degrees), and only 33% of cases achieved satisfactory results.
Conclusions:
- Modular polyethylene exchange may be effective in select TSA cases without concurrent rotator cuff tears or instability.
- The combination of glenoid wear, instability, and rotator cuff tears presents a significant challenge for successful revision surgery.
