Evaluation of the results from partial arthroplasty for treating shoulder osteoarthrosis

Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; Silva, Luciana Andrade da; Sella, Guilherme do Val; Zampieri, Rodrigo; Miranda, Eduardo Régis de Alencar Bona; Checchia, Sergio Luiz

doi:10.1016/j.rboe.2012.05.006

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Original Articles • Rev. bras. ortop. 48 (2) • Apr 2013 • https://doi.org/10.1016/j.rboe.2012.05.006 copy

Evaluation of the results from partial arthroplasty for treating shoulder osteoarthrosis

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

In this study we aim at statistically evaluating the results of the surgical treatment of the osteoarthrosis of the shoulder (OAS) with partial shoulder arthroplasty (PSA) and at correlating them with the several variables involved.

METHODS:

In this study we evaluated 36 shoulders of 31 patients with OAS who underwent treatment with PSA in the Grupo de Ombro e Cotovelo (Group of Shoulders and Elbows) of the Department of Traumatology and Orthopedics of the Faculdade de Ciências Médicas da Santa Casa de São Paulo - Pavillion Fernandinho Simonsen between January, 1989 and November, 2010. Patients who underwent PSA and who had a post-operative follow-up of at least 12 months were included in the study.

RESULTS:

After the surgery the range of elevation, external rotation, internal rotation and the UCLA scale improved (with average differences of 35º, 27º, 4ºand 17 points, respectively), with a significant level of 5% (p < 0.05). For the same level of significance, the relation between a satisfactory UCLA and two variables was found: patients with maximum age of 60 years old at the moment of the surgery and patients that underwent tenotomy of the long head of biceps.

CONCLUSION:

Patients under 60 who underwent surgery and patients who underwent tenotomy of the long head of biceps achieved better results.

Osteoarthritis; Arthroplasty, replacement; Evaluation studies; Shoulder joint

N	Sex	Age	Dominance	Duration of symptoms (months)	Physiotherapy (duration in months)	Length of follow-up (in months)
1	F	70	+	24	3	12
2	M	59	-	6	3	13
3	F	70	-	36	3	28
4	F	68	-	96	6	72
5	F	47	+	24	3	132
6	F	71	-	144	4	36
7	F	44	+	120	36	42
8	F	70	-	18	6	60
9	F	61	ambidextrous RS	12	4	24
10	F	46	-	48	6	72
11	F	85	+	5	7	29
12	F	63	+	60	6	90
13	F	65	-	72	3	72
14	F	79	+	48	6	24
15	F	74	-	30	5	72
16	F	36	-	60	9	24
17	F	74	+	108	6	12
18	F	77	+	30	6	84
19	F	49	+	42	7	24
20	F	72	-	30	18	60
21	F	69	+	48	12	24
22	M	51	-	120	5	24
23	F	41	+	18	6	16
24	F	41	-	18	6	13
25	M	51	+	36	12	54
26	F	22	+	24	24	24
27	F	37	+	36	36	36
28	F	85	-	3	2	24
29	F	75	ambidextrous RS	6	4	84
30	M	31	+	108	7	30
31	F	46	-	48	18	24
32	F	66	+	60	6	12
33	F	39	-	36	3	108
34	F	26	-	60	3	36
35	M	48	+	60	6	72
36	M	53	-	36	3	16

Etiology of shoulder arthrosis.	Number of cases
Primary arthrosis	21 (58.34%)
Primary avascular necrosis	4 (11.11%)
Avascular necrosis secondary to fracture	2 (5.55%)
Avascular necrosis due to sickle-cell anemia	1 (2.78%)
Rheumatoid arthritis	4 (11.11%)
Post-instability arthrosis	2 (5.55%)
Arthrosis following Reiter's syndrome	1 (2.78%)
Post-traumatic arthrosis	1 (2.78%)
Total	36 (100%)

Walch classification	Number of cases
A1	4 (11.11%)
A2	31 (86.12%)
B1	1 (2.77%)
B2	0
C	0

N	Range of motion in degrees before operation			UCLA before operation	Range of motion in degrees			UCLA after operation
	ELV	LR	MR (level)		ELV	LR	MR
1	90	0	Gluteus	15	120	45	L2	25
2	120	-30	L3	13	145	35	T10	29
3	80	0	Gluteus	11	130	40	L5	31
4	80	10	Gluteus	9	135	40	T9	33
5	90	-45	Gluteus	6	120	0	Sacrum	27
6	30	30	Gluteus	8	130	80	Gluteus	34
7	130	60	T9	11	115	40	T9	22
8	130	45	L1	12	150	60	T12	27
9	70	60	T12	6	160	45	T12	31
10	20	45	L5	8	130	45	L1	17
11	30	0	Gluteus	11	150	20	L4	32
12	150	45	L2	15	130	45	L3	31
13	110	0	S1	13	130	45	L3	29
14	130	40	L5	13	150	45	T8	34
15	140	45	L3	13	150	45	T7	32
16	100	45	L3	14	130	60	L1	29
17	100	45	L5	13	150	60	T12	30
18	90	10	Greater trochanter	10	150	70	T8	30
19	90	30	L5	11	140	60	T12	31
20	30	-10	L3	6	150	60	T8	35
21	90	10	L5	10	130	20	T12	27
22	100	10	L5	19	130	30	L1	27
23	90	-15	L2	9	90	40	T12	24
24	90	-15	L4	9	100	45	T12	24
25	100	20	L2	13	160	70	T11	33
26	50	0	Gluteus	9	30	0	Gluteus	4
27	100	20	Gluteus	10	80	35	L4	14
28	80	10	L5	13	140	60	L1	31
29	100	10	S1	11	140	60	T7	15
30	110	-10	L5	16	150	45	T12	35
31	105	10	T9	17	80	20	L2	10
32	80	0	L5	9	110	25	L2	32
33	80	10	L5	11	80	15	L5	17
34	20	30	L3	3	130	45	T7	29
35	100	20	L5	12	110	55	Sacrum	30
36	70	20	Sacrum	11	70	30	Gluteus	24

Walch classification	Number of cases
Associated procedures	4 (11.11%)
Stretching of the subscapularis	31 (86.12%)
Tenotomy of the long head of the biceps	1 (2.77%)
Repair of the rotator cuff	0
Osteotomy of the lesser tubercle	0
Glenoid interposition

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] * Corresponding author at: Santa Casa de Misericórdia de São Paulo, Departamento de Ortopedia e Traumatologia, Pavilhão Fernandinho Simonsen, Rua Dr. Cesário Mota Júnior, 112, Vila Buarque, São Paulo, SP, Brazil, CEP 01220-020, Phone/Fax (0xx11) 3222-6866. Phone: 00 3519 6622 1650. E-mail: ombro@ombro.med.br