title: Cuff tear arthropathy shoulder hemiarthroplasty: a radiographic outcome study.
abstract: OBJECTIVE
  Cuff tear arthropathy (CTA) head prosthesis has recently become an alternative to standard shoulder hemiarthroplasty in patients with severe cuff disease by offering an increased surface area and decreased impingement. The purpose of this study is to evaluate the radiographic outcomes of CTA prosthesis and to correlate them with clinical outcomes.
  
  
  METHODS
  In this retrospective study of CTA hemiarthroplasties over an 11-year period, two radiologists reviewed pre-/postoperative radiographs and clinical data. Radiographic complications were correlated with subsequent surgery using Cox regression models. Rates of surgical revision and radiographic complications over time were estimated using Kaplan-Meier curves.
  
  
  RESULTS
  Ninety-seven CTA hemiarthroplasties were identified in 92 patients (5 bilateral) with a mean patient age of 68.7 years. Mean radiographic follow-up was 12 months with a mean of 3.3 radiographs per prosthesis. Twenty-six arthroplasties (26.8%) experienced at least one radiographic complication, including acromion remodeling (19.5%), anterior-posterior subluxation (5.2%), periprosthetic fracture (4.1%), glenoid remodeling (3.1%), hardware loosening (2.1%), superior subluxation (2.1%), and subsidence (1.0%). Eight cases underwent revision surgery (8.2%). The occurrence of a postoperative radiographic complication was associated with increased risk of surgical revision (hazard ratio 11.5, 95% CI: 2.4-55.7, p = 0.002); 73.5% of radiographic complications occurred by 3 months after the initial surgery (complication rate of 23.3%) based on Kaplan-Meier curve analysis.
  
  
  CONCLUSIONS
  Radiographic complications after CTA head hemiarthroplasty are common with most occurring by 3 months after surgery and are highly associated with surgical revision.
authors.affiliation: Department of Radiology, University of Washington, 1959 N.E. Pacific Street, Box 357115, Seattle, WA, 98195, USA.
authors.forename: Alan S
authors.initials: AS
authors.lastname: Leung
authors.affiliation: Department of Radiology, University of Washington, 850 Republication St, Seattle, WA, 98109, USA.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Hippe
authors.affiliation: Department of Radiology, University of Washington, 4245 Roosevelt Way NE, Box 354755, Seattle, WA, 98105, USA. aha1@uw.edu.
authors.forename: Alice S
authors.initials: AS
authors.lastname: Ha
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement; D005260:Female; D062785:Hemiarthroplasty; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000070656:Rotator Cuff Tear Arthropathy / Q000000981:diagnostic imaging* / Q000601:surgery*; D016896:Treatment Outcome
keywords: Arthroplasty; Joint replacement; Rotator cuff; Shoulder