Cementless total shoulder arthroplasty: preliminary experience with thirteen cases

From February 1978 to March 1981, 13 English-McNab cementless, semiconstrained, implant shoulder arthroplasties were performed in 12 people. The ages of the patients at the time of surgery ranged from 53 to 73 years with an average of 62 years. The preoperative diagnoses were rheumatoid arthritis, primary osteoarthrosis, posttraumatic osteoarthritis, avascular necrosis, and failed hemiarthroplasty. Followup ranged from 27 to 62 months with an average of 44.3 months. Criteria for total shoulder replacement were intractable pain commensurate with destruction of the glenohumeral joint on x-ray. The UCLA shoulder rating system was used for evaluation of pain, function, muscle power, and motion.Preoperative UCLA mean scores were 1.7 for pain, 1.8 for function, 4.0 for muscle power and motion. At followup, mean scores were 6.6, 5.6, and 4.8 respectively. Significant complications occurred.Our conclusions are that uncemented total shoulder arthroplasty with an unconstrained prosthesis can, in selected patients, offer significant relief of pain and increase overall function while modestly improving strength and motion. The complications are consistent with those reported in the literature although loosening of this prosthesis has not been noted.