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ANALYSIS OF FAILURE OF SHOULDER REPLACEMENT FOR OSTEOARTHRITIS



Abstract

The purpose of this study was to analyse the reason for failure of shoulder arthroplasties performed for osteoarthritis, looking specifically at factors associated with either hemi or total shoulder replacement.

Over an eight-year period over 80 consecutive patients undergoing a Global hemi-arthroplasty or total shoulder arthroplasty were looked at. All patients underwent at least two years of follow up. All patients were assessed pre and post operatively using the Constant and ASES scoring systems. A bio-engineer or physiotherapist performed these evaluations. X-rays were analysed for demarcation, loosening and glenoid erosion. Failure was defined as the need for revision surgery. Reasons for revision were predominately pain, loosening and instability. In these instances the differences between hemi and total joint arthroplasty were recorded. A distinct pattern was present with several early revisions being performed for continuing pain in the patient group who underwent hemi-arthroplasty.

In conclusion, this study supports total shoulder replacement as the operation of choice, in suitable patients, as compared to hemi-arthroplasty. This would appear to reduce the risk of the need for early revision on account of pain. This must be weighed against the potential for late glenoid loosening.

These abstracts were prepared by Mr Cormac Kelly. Correspondence should be addressed to him c/o British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN.