None listed
Conditions
Brief summary
Glenoid bone loss is a challenging issue when considering reverse shoulder arthroplasty. The glenoid provides bone stock for fixation of the glenosphere, and any bone loss can affect the position and integrity of the implant. In particular, malposition of the implant due to bone loss can affect the glenohumeral joint line anatomy. Overmedialisation and overlateralisation of the joint line both have their own complications which surgeons must try to avoid. Therefore, restoring the anatomic joint line of the patient in reverse shoulder arthroplasty is paramount to the success of the surgery. This study aims to investigate whether use of metallic augments in reverse shoulder arthroplasty implants can restore glenohumeral joint line anatomy. From a single-centred cohort, all patients who have had a primary reverse shoulder arthroplasty and have had pre-operative CT scans will be included in the study. The native joint line will be mapped using 3D reconstruction of the shoulder, and the position of the joint line recorded. Following surgery, post-operative CT scans will be performed and the new joint line anatomy will be measured and compared with pre-operative position. The interval between the two CT scans will vary on the follow up of the patients, but we anticipate a mean follow up period of 2 years. Study Hypothesis: In patients with bone loss, we hypothesise that use of metallic augments in reverse shoulder joint replacement surgery can restore the anatomy of the shoulder joint to how it was before surgery.
Interventions
Retrospective review of hospital records will identify patients who have had metallic augment implants used in their reverse shoulder arthroplasty during the study period. These patients will be contacted for enrolment into the study. There are approximately ~20 patients eligible for enrolment, and all of these patients will be offered enrolment into the study.
NB: All patients who have had reverse shoulder arthroplasty will have had a pre-operative CT scan as part of the standard work up prio
Retrospective review of hospital records will identify patients who have had metallic augment implants used in their reverse shoulder arthroplasty during the study period. These patients will be contacted for enrolment into the study. There are approximately ~20 patients eligible for enrolment, and all of these patients will be offered enrolment into the study. NB: All patients who have had reverse shoulder arthroplasty will have had a pre-operative CT scan as part of the standard work up prior to their operation. If there are no pre-operative CT scans available, the patient will be excluded from our study. However, not all patients will have post-operative CT scans. Once patients have been enrolled, all patients will then undergo a post-surgery CT scan with 3D rendering. The joint line anatomy will measured on both the pre- and post-operative CT scans, and the differences will be compared. We hypothesise that use of metallic augment can successfully achieve restoration of the patient's pre-operative joint line anatomy. This will be an observational study. The pre- and post-operative joint line anatomy following metallic augment insertion is what we are observing. The participant must undertake a post-operative CT scan and fill in a one-off questionnaire detailing their function and symptoms. We will use externally validated questionnaires e.g. quick disability of the arm, shoulder and hand score (qDASH). The duration of observation is retrospective and dependent on how long ago they had their metallic augment inserted. The time we expect to be able to perform all CT scans is 6 months.
Sponsors
Northland District Health Board
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
primary reverse shoulder arthroplasty, metallic augments, patients with glenoid bone loss
Exclusion criteria
previous shoulder surgery, concurrent use of bone graft, CT scan follow up less than 3 months from initial surgery
Outcome results
None listed