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Results of Anatomical Shoulder Arthroplasty

  • Clemens Abel
  • Frank GohlkeEmail author
Chapter

Abstract

Results of anatomical shoulder arthroplasty depend on numerous factors: patient-related, surgeon-related and, most importantly, aetiology-related. The precondition of the rotator cuff and the amount of glenoid bone loss and deformity are essential for longevity of the implant. In cases of centred osteoarthritis and intact rotator cuff without advanced fatty muscle infiltration good or excellent functional results can be expected for the majority of patients with low complication rates for the first 10 years after surgery.

The trend to preserve bone stock using stemless humeral components has not yet produced differences in clinical outcome or loosening rates in comparison to stemmed implants yet. However, this needs more long-term survivorship data. While improvements have been made on the humeral component side, glenoid fixation still seems to be the most important limiting factor for implant survival in the mid- to long-term. Glenoid loosening is still the most common failure mode: caused by aseptic loosening of cemented polyethylene glenoid components after 5–10 years and in metal-backed components due to increased polyethylene wear and dissociation after 4–6 years. Although considerable thought has been spent on the design of the glenoid component, it does not seem to have influenced the long-term survival and revision rate significantly. A new approach to glenoid resurfacing has to overcome this crucial issue.

Keywords

Anatomic shoulder arthroplasty Glenoid component Humeral component Survivalship Patient related outcome factors Osteoarthritis Rheumatoid arthritis Glenoid component design Status of rotator cuff Humeral stem length Metal backed glenoid 

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.KLinik für Schulterchirurgie, Rhön Kliniken, Campus Bad NeusrtadtBad Neustadt an der SaaleGermany

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