Total Shoulder Arthroplasty is associated With Less Pain and Better Functional Outcomes, but Humeral Head Resurfacing may be Preferred in Younger, Higher Demand Patients: A Short-Term Outcomes Study in Patients with Glenohumeral Osteoarthritis
نویسندگان
1 Freddie Fu Sports Medicine Center- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
2 Freddie Fu Sports Medicine Center- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
3 Freddie Fu Sports Medicine Center- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
4 Freddie Fu Sports Medicine Center- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
5 Freddie Fu Sports Medicine Center- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
6 Summit Health Orthopaedics, Florham Park, NJ, USA
7 Hospital for Special Surgery, New York, NY, USA
8 Rothman Orthopaedics, Orlando, FL, USA
9 Freddie Fu Sports Medicine Center- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
doi
10.22038/abjs.2024.72211.3364چکیده
Objectives: This study aimed to compare short-term outcomes following Total Shoulder Arthroplasty (TSA) and Humeral Head Resurfacing (HHR) in patients with glenohumeral osteoarthritis (GHOA).Methods: A retrospective analysis included patients who had undergone either TSA or HHR for GHOA at a single institution. Baseline demographics, complications, range of motion (active forward flexion, FF and active external rotation, ER), visual analog scores (VAS), and Subjective Shoulder Values (SSV) were collected.Results: A total of 69 TSA and 56 HHR patients were analyzed. More HHR patients were laborers (44% versus 21%, P=0.01). There were more smokers in the TSA group (25% versus 11%, P=0.04) and more cardiovascular disease in the HHR cohort (64% versus. 6%, p<0.0001). Postoperative FF was similar, but ER was greater in the HHR (47° ± 15°) vs. TSA group (40° ± 12°, P = 0.01). VAS was lower after TSA vs. HHR (median 0, IQR 1 versus median 3.7, IQR 6.9, p<0.0001), and SSV was higher after TSA (89% ± 13% vs. 75% ± 20% after HHR; p<0.0001). Post-operative impingement was more common after HHR (32% vs. 3% for TSA, p<0.0001). All other complications were equivalent.Conclusion: While younger patients and heavy laborers had improved ER following HHR, their pain relief was greater after TSA. Decisions on surgical technique should be based on patient-specific demographic and anatomic factors. Level of evidence: III
