TY - JOUR
T1 - Poor patient-reported outcome after shoulder replacement in young patients with cuff-tear arthropathy
T2 - a matched-pair analysis from the Danish Shoulder Arthroplasty Registry
AU - Ammitzboell, Mette
AU - Baram, Amin
AU - Brorson, Stig
AU - Olsen, Bo Sanderhoff
AU - Rasmussen, Jeppe V
PY - 2019/4
Y1 - 2019/4
N2 - Background and purpose - Reverse shoulder arthroplasty (RSA) has become the treatment of choice for cuff-tear arthropathy. There are, however, concerns about the longevity and the outcome of an eventual revision procedure. Thus, resurfacing hemiarthroplasty (RHA) with extended articular surface has been suggested for younger patients. We compared the patient-reported outcome of these arthroplasty designs for cuff-tear arthropathy. Patients and methods - We included patients operated on because of cuff-tear arthropathy and reported to the Danish Shoulder Arthroplasty Registry (DSR) from January 1, 2006 to December 31, 2013. 117 RHA cases were matched by age and sex with 233 RSA controls. 34 of the RHAs were conventional and 67 were RHAs with extended articular surface. The Western Ontario Osteoarthritis of the Shoulder (WOOS) Index at 1 year was used as primary outcome. The score was converted to a percentage of a maximum score. Revision, defined as removal or exchange of any component or the addition of a glenoid component, was used as secondary outcome. Results - Median WOOS was 49 (30-81) for RHA and 77 (50-92) for RSA (p < 0.001). For patients younger than 65 years, median WOOS was 58 (44-80) after RHA, similar to the 54 after RSA (37-85). For patients older than 65 years, median WOOS was 48 (28-82) after RHA and 79 (55-92) after RSA (p < 0.001). Interpretation - In all patients RSA had a clinically and statistically better patient-reported outcome than RHA. However, in patients younger than 65 years the functional outcome was similar and poor for either arthroplasty type. The optimal treatment of CTA in young patients remains a challenge.
AB - Background and purpose - Reverse shoulder arthroplasty (RSA) has become the treatment of choice for cuff-tear arthropathy. There are, however, concerns about the longevity and the outcome of an eventual revision procedure. Thus, resurfacing hemiarthroplasty (RHA) with extended articular surface has been suggested for younger patients. We compared the patient-reported outcome of these arthroplasty designs for cuff-tear arthropathy. Patients and methods - We included patients operated on because of cuff-tear arthropathy and reported to the Danish Shoulder Arthroplasty Registry (DSR) from January 1, 2006 to December 31, 2013. 117 RHA cases were matched by age and sex with 233 RSA controls. 34 of the RHAs were conventional and 67 were RHAs with extended articular surface. The Western Ontario Osteoarthritis of the Shoulder (WOOS) Index at 1 year was used as primary outcome. The score was converted to a percentage of a maximum score. Revision, defined as removal or exchange of any component or the addition of a glenoid component, was used as secondary outcome. Results - Median WOOS was 49 (30-81) for RHA and 77 (50-92) for RSA (p < 0.001). For patients younger than 65 years, median WOOS was 58 (44-80) after RHA, similar to the 54 after RSA (37-85). For patients older than 65 years, median WOOS was 48 (28-82) after RHA and 79 (55-92) after RSA (p < 0.001). Interpretation - In all patients RSA had a clinically and statistically better patient-reported outcome than RHA. However, in patients younger than 65 years the functional outcome was similar and poor for either arthroplasty type. The optimal treatment of CTA in young patients remains a challenge.
KW - Aged
KW - Arthroplasty, Replacement, Shoulder/adverse effects
KW - Denmark/epidemiology
KW - Female
KW - Hemiarthroplasty/adverse effects
KW - Humans
KW - Male
KW - Matched-Pair Analysis
KW - Middle Aged
KW - Osteoarthritis/diagnosis
KW - Patient Reported Outcome Measures
KW - Postoperative Complications/diagnosis
KW - Recovery of Function
KW - Registries
KW - Reoperation/methods
KW - Rotator Cuff Injuries/complications
KW - Rotator Cuff Tear Arthropathy/epidemiology
KW - Shoulder Joint/physiopathology
KW - Treatment Outcome
U2 - 10.1080/17453674.2018.1563855
DO - 10.1080/17453674.2018.1563855
M3 - Article
C2 - 30669910
VL - 90
SP - 119
EP - 122
JO - Acta Orthopaedica
JF - Acta Orthopaedica
SN - 1745-3674
IS - 2
ER -