Total shoulder arthroplasty after coracoid transfer yielded adequate results
Click Here to Manage Email Alerts
Total shoulder arthroplasty after coracoid transfer showed results similar to total shoulder arthroplasty for primary osteoarthritis, according to results from a recently published study.
“Several studies have highlighted the technical challenge of shoulder arthroplasty following a coracoid transfer procedure,” Michael J. Bender, MD, at Methodist Sports Medicine, Texas Education and Research Foundation for Shoulder and Elbow Surgery, and colleagues wrote. “The purpose of this study was to evaluate minimum 2-year outcomes following anatomic total shoulder arthroplasty (TSA) for instability arthroplasty with a prior coracoid transfer procedure and compare them with a matched cohort of patients following TSA for primary osteoarthritis.”
In a retrospective database review, 11 primary anatomic TSAs performed for instability arthropathy with a prior coracoid transfer procedure were identified along with a matched cohort of 33 patients with TSA for primary osteoarthritis. Patients in both cohorts, with a minimum of 2 years follow-up, were assessed for American Shoulder and Elbow Surgeons (ASES) score, a single assessment numeric evaluation (SANE) score and patient satisfaction.
Study outcomes showed no significant differences between the coracoid transfer cohort and the matched cohort in final ASES score (88 vs. 82, respectively) or SANE score (85 vs. 67, respectively). Further investigation of postoperative ASES pain scores showed higher results in the coracoid transfer cohort compared to the matched cohort (45 vs. 41), while preoperative to postoperative improvement for ASES score, ASES pain score and SANE score showed no significant differences. Two patients from each cohort underwent revision, and overall patient satisfaction was reported as improved in both cohorts.
“At early to midterm follow-up, TSA performed after coracoid transfer demonstrated similar results to TSA performed for primary osteoarthritis,” Bender and colleagues concluded. “Longer-term follow-up and larger patient cohorts will provide further insights into this issue and highlight any potential differenced in outcomes or revision rates.”
Perspective
Back to Top
Mark A. Frankle, MD, Derek J. Cuff, MD
The paper by Edwards and colleagues demonstrates anatomic total shoulder arthroplasty in properly selected patients that develop secondary osteoarthritis after previous Latarjet procedure can be successful if the subscapularis is functional and there is concentric glenoid bone loss. However, if the subscapularis is atrophied or there is significant glenoid bone loss, reverse shoulder arthroplasty is the preferred option. To best understand improvement on outcomes after shoulder arthroplasty as well as treatment selection when counseling patients, it is vital that we also describe the surgical pathology (including intraoperative observations) with the surgical treatment and resultant outcomes.
Collapse
Read more about
Click Here to Manage Email Alerts