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CAD/CAM implant may be revision arthroplasty alternative for patients with glenoid bone loss
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For patients with advanced glenoid bone loss who failed post-traumatic humeral head replacement, the use of a CAD/CAM shoulder prosthesis may be a viable alternative to revision shoulder arthroplasty, according to results of this study.
“In our opinion, this prosthetic design should be considered as an alternative to [reverse total shoulder arthroplasty] RTSA only in glenoid-deficient shoulders, when the ability to achieve secure fixation of a glenoid component is questionable,” Ofir Uri, MD, and colleagues wrote in the study.
Between 2005 and 2010, 24 patients received a CAD/CAM shoulder prosthesis (Stanmore Implants; Elstree, U.K.) instead of undergoing glenoid grafting and reconstruction. Overall, 21 patients were included in the data analysis. Patient age ranged from 56 years to 86 years.
Revision arthroplasty was performed at a mean of 30 months to 168 months after the original humeral head replacement and post-revision follow-up was performed at a mean of 24 months to 72 months. Researchers assessed patients pre-revision and post-revision through physical examination and shoulder questionnaires.
Pain scores decreased from 5.6 at rest and 7.4 when active, to 1.1 at rest and 2.1 when active. Researchers saw a significant improvement in pain and clinical scores at 3 years’ follow-up, and reported no cases of glenoid loosening.
Nine patients had postoperative complications, such as infection, periprosthetic fracture, prosthetic dislocation and fixation screw fracture. Researchers reported no incidence of glenoid loosening.
“The CAD/CAM shoulder offers a reliable method of securing a glenoid component in shoulders with advanced glenoid deficiency and should be considered as an alternative to other surgical methods in these challenging cases,” Uri and colleagues wrote in the abstract.
Researchers noted additional studies are needed, citing study limitations such as a lack of a control group.
Disclosures: The authors have no relevant financial disclosures.
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