title: Impact of prosthetic design on clinical and radiologic outcomes of total shoulder arthroplasty: a prospective study.
abstract: BACKGROUND
  This prospective longitudinal study compared clinical and radiologic outcomes of total shoulder arthroplasty (TSA) using 3 different prosthetic designs, the Neer II system, the Bigliani-Flatow (BF), and a stemless prosthesis, the Total Evolutive Shoulder System (TESS).
  
  
  METHODS
  Patients with advanced osteoarthritis of the glenohumeral joint who underwent TSA were followed up for 2 years. Four patient-oriented disability outcomes were used. The clinical data collected before surgery and at follow-up assessments during a 2-year period included active range of motion (ROM) in 6 directions and strength. Radiographic signs of glenoid and humeral component loosening were recorded. The incidence of humeral head subluxation was documented.
  
  
  RESULTS
  Seventy-four patients completed the study. There was a significant improvement in the 4 disability measures, ROM, and strength at 2 years in all 3 groups (P < .0001). Active external rotation at 90° abduction was statistically significantly lower in the Neer II group (P = .001). The incidence of lucent lines around the glenoid component was higher in the Neer II group (P = .0002). No statistically significant relationship was seen between type of prosthesis and patient satisfaction (P > 0.05).
  
  
  CONCLUSIONS
  The 3 types of TSA prostheses used in this study all provided significant improvement in pain and function and were associated with high patient satisfaction. The Neer II was associated with less active external rotation and more lucent lines.
authors: Department of Rehabilitation, Holland Orthopedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. helen.razmjou@sunnybrook.ca
authors: Helen
authors: H
authors: Razmjou
authors: Richard
authors: R
authors: Holtby
authors: Monique
authors: M
authors: Christakis
authors: Terry
authors: T
authors: Axelrod
authors: Robin
authors: R
authors: Richards
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D011446:Prospective Studies; D011474:Prosthesis Design; D011859:Radiography; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D016896:Treatment Outcome