Achievement of the patient acceptable symptom state following total shoulder arthroplasty with nonspherical humeral head and inlay glenoid

Shoulder Elbow. 2024 Jun 18:17585732241262742. doi: 10.1177/17585732241262742. Online ahead of print.

Abstract

Background: Total shoulder arthroplasty (TSA) with a nonspherical humeral head component and inlay glenoid is a bone preserving treatment for glenohumeral arthritis. This study aims to describe minimum two year patient reported outcomes, patient acceptable symptomatic state (PASS) achievement, and complications following TSA with this prosthesis.

Methods: A retrospective review of patients undergoing TSA with nonspherical humeral head and inlay glenoid was performed. Outcomes included Single Assessment Numeric Evaluation (SANE) scores, American Shoulder and Elbow Surgeons (ASES) scores, and complications. SANE and ASES scores were compared to established PASS threshold values to determine PASS achievement.

Results: 56 TSA in 53 patients were identified. The mean age was 64.5 years, 64% were male, and mean follow-up was 29.2 ± 4.9 months (24.0-42.8). Two complications (3.6%) were observed: one subscapularis tear requiring revision to reverse TSA and one traumatic minimally displaced greater tuberosity fracture successfully treated nonoperatively. The mean SANE score was 84.3 ± 16.9 (40-100) and 77% of patients surpassed the PASS threshold of 75.5. The mean ASES score was 85.3 ± 15.7 (40-100) and 77% of patients surpassed the PASS threshold of 76.

Discussion: Patients undergoing TSA with a nonspherical humeral head and inlay glenoid demonstrated high PASS achievement rates and few complications at short-term follow-up.

Keywords: Total shoulder arthroplasty; complications; inlay glenoid; nonspherical humeral head; patient reported outcomes.