An evaluation of the radiological changes around the Grammont reverse geometry shoulder arthroplasty after eight to 12 years

Author:

Melis B.1,DeFranco M.2,Lädermann A.3,Molé D.4,Favard L.5,Nérot C.6,Maynou C.7,Walch G.1

Affiliation:

1. Centre Orthopédique Santy, 24 Av Paul Santy, 69008 Lyon, France.

2. Lenox Hill Hospital, 100 East 77th Street, New York, NY 10075, USA.

3. University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Genève 14, Switzerland.

4. Clinique de Traumatologie et d’Orthopédie, 49 Rue Hermite, 54000 Nancy, France.

5. CHU Trousseau, Chirurgie Orthopédique et Traumatologique, Avenue de la République, 37170 Chambraylès-Tours, France.

6. CHU de Reims, Traumatologie, 45 avenue Cognacq Jay, 51100 Reims, France.

7. CHRU de Lille, service de Chirurgie Orthopédique, 2 avenue Oscar-Lambret, 59037 Lille, France.

Abstract

Radiological changes and differences between cemented and uncemented components of Grammont reverse shoulder arthroplasties (DePuy) were analysed at a mean follow-up of 9.6 years (8 to 12). Of 122 reverse shoulder arthroplasties implanted in five shoulder centres between 1993 and 2000, a total of 68 (65 patients) were available for study. The indications for reversed shoulder arthroplasty were cuff tear arthropathy in 48 shoulders, revision of shoulder prostheses of various types in 11 and massive cuff tear in nine. The development of scapular notching, bony scapular spur formation, heterotopic ossification, glenoid and humeral radiolucencies, stem subsidence, radiological signs of stress shielding and resorption of the tuberosities were assessed on standardised true anteroposterior and axillary radiographs. A scapular notch was observed in 60 shoulders (88%) and was associated with the superolateral approach (p = 0.009). Glenoid radiolucency was present in 11 (16%), bony scapular spur and/or ossifications in 51 (75%), and subsidence of the stem and humeral radiolucency in more than three zones were present in three (8.8%) and in four (11.8%) of 34 cemented components, respectively, and in one (2.9%) and two (5.9%) of 34 uncemented components, respectively. Radiological signs of stress shielding were significantly more frequent with uncemented components (p < 0.001), as was resorption of the greater (p < 0.001) and lesser tuberosities (p = 0.009).

Publisher

British Editorial Society of Bone & Joint Surgery

Subject

Orthopedics and Sports Medicine,Surgery

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