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Risk Factors for Stiffness Requiring Intervention After Ream-and-Run Arthroplasty.

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Younger patients, lower American Society of Anesthesiologists (ASA) class, and limited shoulder mobility after ream-and-run arthroplasty increase the risk of repeat procedures for stiffness. Identifying these factors aids in managing glenohumeral arthritis outcomes.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Clinical Research

Background:

  • Ream-and-run arthroplasty offers an alternative to traditional prosthetic glenoid components for glenohumeral arthritis, potentially reducing complications.
  • Postoperative stiffness remains a significant concern, necessitating interventions like manipulation under anesthesia (MUA) or open revision surgery.

Purpose of the Study:

  • To identify risk factors associated with repeat procedures for postoperative stiffness following ream-and-run arthroplasty.
  • To analyze demographic, clinical, and radiographic factors influencing the need for MUA or revision surgery.

Main Methods:

  • Retrospective review of a shoulder arthroplasty database.
  • Inclusion of patients who underwent ream-and-run arthroplasty with a minimum 2-year follow-up.
  • Collection of demographic data, patient-reported outcomes, and radiographic analysis; univariate and multivariate statistical analyses were performed.

Main Results:

  • Of 340 patients, 7.6% required open revision and 10.3% underwent MUA for stiffness.
  • Univariate analysis identified younger age, female sex, lower ASA class, posterior decentering, and reduced discharge passive forward elevation as risk factors.
  • Multivariate analysis confirmed younger age, ASA class 1 vs. 3, and less discharge passive forward elevation as independent risk factors.

Conclusions:

  • Younger age, lower ASA class, and diminished immediate postoperative passive forward elevation are independent predictors of repeat procedures for stiffness after ream-and-run arthroplasty.
  • These findings highlight key patient and procedural factors that may predispose individuals to stiffness and subsequent interventions.