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Are there differences between stemless and conventional stemmed shoulder prostheses in the treatment of glenohumeral osteoarthritis?

Maier MW, Lauer S, Klotz MC, Bülhoff M, Spranz D, Zeifang F - BMC Musculoskelet Disord (2015)

Bottom Line: The pre- and postoperative Constant Score (CS) was evaluated and proprioception was measured in a 3D video motion analysis study using an active angle-reproduction (AAR) test.There was no significant difference in postoperative proprioception between the TESS group (7.2° [SD ± 2.8]) and the Aequalis group(8.7° [SD ± 2.7]; p = 0.196), either.Comparison of in the results of CS and AAR test pre- and postoperatively showed no significant differences between the groups.

View Article: PubMed Central - PubMed

Affiliation: Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstraße 200a, D-69118, Heidelberg, Germany. m.w.maier@web.de.

ABSTRACT

Background: Conventional stemmed anatomical shoulder prostheses are widely used in the treatment of glenohumeral osteoarthritis. The stemless shoulder prosthesis, in contrast, is a new concept, and fewer outcome studies are available. Therefore, the purpose of the study was to investigate the early functional outcome and postoperative proprioception of a stemless prosthesis in comparison with a standard stemmed anatomic shoulder prosthesis.

Methods: Twelve patients (mean age 68.3 years [SD ± 5.4]; 5 female, 7 male) with primary glenohumeral osteoarthritis of the shoulder were enrolled, who underwent total shoulder arthroplasty (TSA) with a stemless total shoulder prosthesis, Total Evolution Shoulder System (TESS; Biomed, France). The control group consisted of twelve (age and gender matched) patients (mean age 67.8 years; [SD ± 7.1]; 9 female, 3 male), getting a TSA with a standard anatomic stemmed prosthesis, Aequalis Shoulder (Tournier, Lyon, France). Patients were examined the day before and six months after surgery. The pre- and postoperative Constant Score (CS) was evaluated and proprioception was measured in a 3D video motion analysis study using an active angle-reproduction (AAR) test.

Results: Comparing the postoperative CS, there was no significant difference between the groups treated with the TESS prosthesis (48.0 ± 13.8 points) and the Aequalis prosthesis (49.3 ± 8.6 points; p = 0.792). There was no significant difference in postoperative proprioception between the TESS group (7.2° [SD ± 2.8]) and the Aequalis group(8.7° [SD ± 2.7]; p = 0.196), either. Comparison of in the results of CS and AAR test pre- and postoperatively showed no significant differences between the groups.

Discussion: In patients with glenohumeral osteoarthritis, treated with TSA, the functional and the proprioceptive outcome is comparable between a stemless and a standard stemmed anatomic shoulder prosthesis at early followup.

Conclusion: Further follow-up is necessary regarding the long-term performance of this prosthesis.

Trial registration: Current Controlled Trials DRKS 00007528 . Registered 17 November 2014.

No MeSH data available.


Related in: MedlinePlus

The stemless (TESS®) group displayed no significant differences between pre- and postoperative AAR
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Fig2: The stemless (TESS®) group displayed no significant differences between pre- and postoperative AAR

Mentions: In the STEMLESS group the total proprioception, defined as the mean value of all single measurements (six joint positions), did not display any significant changes six months after surgery (Fig. 2). By trend proprioception had deteriorated in five of six single measurements. Only at 60° of abduction (60° abd) was no deterioration observed (Fig. 2). The CONTROL group also revealed no significant changes six months after surgery. By trend, proprioception had deteriorated in five of six single measurements (Fig. 2). Comparison of postoperative proprioception showed no significant difference between TESS® group (7.2° [SD ± 2.8]) and Aequalis® group (8.7° [SD ± 2.7]; p = 0.196; Fig. 3)). By trend, postoperative proprioception was better in the STEMLESS group in five of six single measurements (Fig. 3). Comparing the overall differences between pre- and postoperative AAR, there is no significant difference between the STEMLESS (1.3° [SD 3.1]) and CONTROL groups (1.4° [SD 2.7]; p = 0.935; Fig. 4; Table 2).Fig. 2


Are there differences between stemless and conventional stemmed shoulder prostheses in the treatment of glenohumeral osteoarthritis?

Maier MW, Lauer S, Klotz MC, Bülhoff M, Spranz D, Zeifang F - BMC Musculoskelet Disord (2015)

The stemless (TESS®) group displayed no significant differences between pre- and postoperative AAR
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4591701&req=5

Fig2: The stemless (TESS®) group displayed no significant differences between pre- and postoperative AAR
Mentions: In the STEMLESS group the total proprioception, defined as the mean value of all single measurements (six joint positions), did not display any significant changes six months after surgery (Fig. 2). By trend proprioception had deteriorated in five of six single measurements. Only at 60° of abduction (60° abd) was no deterioration observed (Fig. 2). The CONTROL group also revealed no significant changes six months after surgery. By trend, proprioception had deteriorated in five of six single measurements (Fig. 2). Comparison of postoperative proprioception showed no significant difference between TESS® group (7.2° [SD ± 2.8]) and Aequalis® group (8.7° [SD ± 2.7]; p = 0.196; Fig. 3)). By trend, postoperative proprioception was better in the STEMLESS group in five of six single measurements (Fig. 3). Comparing the overall differences between pre- and postoperative AAR, there is no significant difference between the STEMLESS (1.3° [SD 3.1]) and CONTROL groups (1.4° [SD 2.7]; p = 0.935; Fig. 4; Table 2).Fig. 2

Bottom Line: The pre- and postoperative Constant Score (CS) was evaluated and proprioception was measured in a 3D video motion analysis study using an active angle-reproduction (AAR) test.There was no significant difference in postoperative proprioception between the TESS group (7.2° [SD ± 2.8]) and the Aequalis group(8.7° [SD ± 2.7]; p = 0.196), either.Comparison of in the results of CS and AAR test pre- and postoperatively showed no significant differences between the groups.

View Article: PubMed Central - PubMed

Affiliation: Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstraße 200a, D-69118, Heidelberg, Germany. m.w.maier@web.de.

ABSTRACT

Background: Conventional stemmed anatomical shoulder prostheses are widely used in the treatment of glenohumeral osteoarthritis. The stemless shoulder prosthesis, in contrast, is a new concept, and fewer outcome studies are available. Therefore, the purpose of the study was to investigate the early functional outcome and postoperative proprioception of a stemless prosthesis in comparison with a standard stemmed anatomic shoulder prosthesis.

Methods: Twelve patients (mean age 68.3 years [SD ± 5.4]; 5 female, 7 male) with primary glenohumeral osteoarthritis of the shoulder were enrolled, who underwent total shoulder arthroplasty (TSA) with a stemless total shoulder prosthesis, Total Evolution Shoulder System (TESS; Biomed, France). The control group consisted of twelve (age and gender matched) patients (mean age 67.8 years; [SD ± 7.1]; 9 female, 3 male), getting a TSA with a standard anatomic stemmed prosthesis, Aequalis Shoulder (Tournier, Lyon, France). Patients were examined the day before and six months after surgery. The pre- and postoperative Constant Score (CS) was evaluated and proprioception was measured in a 3D video motion analysis study using an active angle-reproduction (AAR) test.

Results: Comparing the postoperative CS, there was no significant difference between the groups treated with the TESS prosthesis (48.0 ± 13.8 points) and the Aequalis prosthesis (49.3 ± 8.6 points; p = 0.792). There was no significant difference in postoperative proprioception between the TESS group (7.2° [SD ± 2.8]) and the Aequalis group(8.7° [SD ± 2.7]; p = 0.196), either. Comparison of in the results of CS and AAR test pre- and postoperatively showed no significant differences between the groups.

Discussion: In patients with glenohumeral osteoarthritis, treated with TSA, the functional and the proprioceptive outcome is comparable between a stemless and a standard stemmed anatomic shoulder prosthesis at early followup.

Conclusion: Further follow-up is necessary regarding the long-term performance of this prosthesis.

Trial registration: Current Controlled Trials DRKS 00007528 . Registered 17 November 2014.

No MeSH data available.


Related in: MedlinePlus