title: Lateral meniscus allograft biologic glenoid arthroplasty in total shoulder arthroplasty for young shoulders with degenerative joint disease.
abstract: To avoid potential polyethylene problems in younger shoulders with degenerative joint disease (DJD) requiring arthroplasty, lateral meniscus allograft (LMA) was used as a biologic resurfacing of the glenoid. We report preliminary, short-term results of this technique in a younger, higher-demand population. The shoulders of 20 men and 10 women, with an average age of 42 years (range, 18 to 52 years), underwent total shoulder arthroplasty with a LMA. A metallic prosthesis was used on the humerus. Etiology of the DJD was osteoarthritis in 16, postinstability surgery in 8, traumatic in 4, and failed open reduction with internal fixation in 2. Twenty-two (73%) had previous shoulder surgery. Preoperative average scores were American Shoulder and Elbow Surgeons (ASES), 38; Simple Shoulder Test (SST), 3.3; and Visual Analogue Scale (VAS), 6.4. The average active forward elevation was 96 degrees and external rotation was 26 degrees . Average follow-up was 18 months (range, 12 to 48 months). Postoperative average scores were ASES, 69; SST, 7.8; and VAS, 2.3. Active forward elevation was 139 degrees and external rotation was 53 degrees . All were significant improvements (P < .02). Most (94%) would have the surgery again. Radiologic evaluation at 1 year revealed an average joint space of 1.8 mm on anteroposterior views and 1.6 mm on axillary views. Five complications (17%) occurred within the first postoperative year, all of which required reoperation. Pain resulted in 2 conversions to a polyethylene glenoid. Polyethylene glenoids in young shoulders risk early failure. For young, high-demand shoulders with DJD requiring arthroplasty, the LMA shows promise. Most problems presented within the first year. Although not perfect, it provided significant pain relief, range-of-motion gains, and patient satisfaction without the risk of poly wear or loosening. Longer-term follow-up will be required to determine ultimate durability.
authors.affiliation: Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL 60612, USA. Orthonick@comcast.net
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Nicholson
authors.forename: Jordan L
authors.initials: JL
authors.lastname: Goldstein
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Romeo
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Cole
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Hayden
authors.forename: Stacy L
authors.initials: SL
authors.lastname: Twigg
authors.forename: L Pearce
authors.initials: LP
authors.lastname: McCarty
authors.forename: Alvin J
authors.initials: AJ
authors.lastname: Detterline
mesh_terms: D000293:Adolescent; D000328:Adult; D019643:Arthroplasty, Replacement / Q000379:methods*; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D008592:Menisci, Tibial / Q000637:transplantation*; D008875:Middle Aged; D016059:Range of Motion, Articular; D012785:Shoulder Joint / Q000601:surgery*; D014184:Transplantation, Homologous