title: Semiconstrained total shoulder arthroplasty for glenohumeral arthritis and massive rotator cuff tearing.
abstract: Each of 6 patients (7 shoulders) underwent semiconstrained total shoulder arthroplasty for glenohumeral arthritis, subluxation, and extensive rotator cuff tearing to obtain a more balanced joint and achieve consistent pain relief. A hooded glenoid component (Neer 600%) was used to contain the humeral head within the joint. Patients were followed for an average of 69 months (range, 26-125 months) or to revision surgery and were assessed clinically and radiographically. All patients experienced improvement with respect to pain; on average, active elevation and external rotation decreased to 44 degrees and 43 degrees. On radiographic evaluation, 3 of the glenoid components were seen to have complete radiolucent lines and 1 case showed a shift in component position. Five shoulders had anterior-superior joint subluxation. According to the shoulder score rating system of Neer, all but 1 of the shoulders were rated as unsatisfactory or unsuccessful at final follow-up. Two patients have undergone revision surgery for subluxation or glenoid loosening. We cannot recommend this method of treatment.
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minn. 55905, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Nwakama
authors.forename: R H
authors.initials: RH
authors.lastname: Cofield
authors.forename: B F
authors.initials: BF
authors.lastname: Kavanagh
authors.forename: J F
authors.initials: JF
authors.lastname: Loehr
mesh_terms: D000368:Aged; D019643:Arthroplasty, Replacement / Q000379:methods*; D005260:Female; D006801:Humans; D007593:Joint Instability; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000473:pathology / Q000601:surgery*; D010146:Pain; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000473:pathology / Q000601:surgery*; D012785:Shoulder Joint / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome