Comparison of Humeral-Head Replacement with Glenoid-Reaming Arthroplasty (Ream and Run) Versus Anatomic Total Shoulder Arthroplasty: A Matched-Cohort Study

Glenoid component failure is a major concern after anatomic total shoulder arthroplasty (aTSA). Ream and run (RnR) is an alternative procedure that may avoid glenoid-related complications. The purpose of this study was to compare outcomes of RnR versus aTSA in younger patients with advanced glenohum...

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Veröffentlicht in:Journal of bone and joint surgery. American volume 2023-04, Vol.105 (7), p.509-517
Hauptverfasser: Levins, James, Molla, Vadim, Adkins, Jacob, Molino, Janine, Pasarelli, Emily, Paxton, E. Scott, Green, Andrew
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Sprache:eng
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Zusammenfassung:Glenoid component failure is a major concern after anatomic total shoulder arthroplasty (aTSA). Ream and run (RnR) is an alternative procedure that may avoid glenoid-related complications. The purpose of this study was to compare outcomes of RnR versus aTSA in younger patients with advanced glenohumeral osteoarthritis. This was a retrospective matched-cohort study of 110 patients who underwent aTSA and 57 patients who underwent RnR; patients were 5-year follow-up, there were no significant differences between the cohorts in the percentage who achieved the MCID, SCB, or patient acceptable symptom state (PASS) for the ASES, SST, and VAS for pain. Three patients underwent revision arthroplasty for pain after RnR, at a mean of 1.9 ± 1.7 years. Two patients underwent revision arthroplasty for glenoid loosening at 9.2 and 14 years after aTSA. RnR and aTSA had comparable outcomes in most analyses. The greater early revision rate after RnR should focus attention on optimizing patient selection and postoperative management. Revision for glenoid loosening is a concern among younger and active patients. Longer-term study is needed to better understand the relative benefits and disadvantages of these procedures. Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.
ISSN:0021-9355
1535-1386
DOI:10.2106/JBJS.22.00650