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Restoration of the joint geometry and outcome after stemless TESS shoulder arthroplasty

AIM: To evaluate the joint geometry and the clinical outcome of stemless, anatomical shoulder arthroplasty with the TESS system. METHODS: Twenty-one shoulders with a mean follow-up 18 of months were included. On scaled digital radiographs the premorbid center of rotation (CoR) was assessed and compa...

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Autores principales: von Engelhardt, Lars V, Manzke, Michael, Breil-Wirth, Andreas, Filler, Timm J, Jerosch, Joerg
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656495/
https://www.ncbi.nlm.nih.gov/pubmed/29094010
http://dx.doi.org/10.5312/wjo.v8.i10.790
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author von Engelhardt, Lars V
Manzke, Michael
Breil-Wirth, Andreas
Filler, Timm J
Jerosch, Joerg
author_facet von Engelhardt, Lars V
Manzke, Michael
Breil-Wirth, Andreas
Filler, Timm J
Jerosch, Joerg
author_sort von Engelhardt, Lars V
collection PubMed
description AIM: To evaluate the joint geometry and the clinical outcome of stemless, anatomical shoulder arthroplasty with the TESS system. METHODS: Twenty-one shoulders with a mean follow-up 18 of months were included. On scaled digital radiographs the premorbid center of rotation (CoR) was assessed and compared to the CoR of the prosthesis by using the MediCAD(®) software. Additionally, the pre- and post-operative geometry of the CoR was assessed in relation to the glenoid, the acromion as well as to the proximal humerus. Radiological changes, such as radiolucencies, were also assessed. Clinical outcome was assessed with the Constant and DASH score. RESULTS: Both, the Constant and DASH scores improved significantly from 11% to 75% and from 70 to 30 points, P < 0.01 respectively. There were no significant differences regarding age, etiology, cemented or metal-backed glenoids, etc. (P > 0.05). The pre- and postoperative humeral offset, the lateral glenohumeral offset, the height of the CoR, the acromiohumeral distance as well as neck-shaft angle showed no significant changes (P > 0.05). The mean deviation of the CoR of the prosthesis from the anatomic center was 1.0 ± 2.8 mm. Three cases showed a medial deviation of more than 3 mm. These deviations of 5.1, 5.7 and 7.6 mm and were caused by an inaccurate humeral neck cut. These 3 patients showed a relatively poor outcome scoring. CONCLUSION: TESS arthroplasty allows an anatomical joint reconstruction with a very good outcome. Outliers described in this study sensitize the surgeon for an accurate humeral neck cut.
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spelling pubmed-56564952017-11-01 Restoration of the joint geometry and outcome after stemless TESS shoulder arthroplasty von Engelhardt, Lars V Manzke, Michael Breil-Wirth, Andreas Filler, Timm J Jerosch, Joerg World J Orthop Observational Study AIM: To evaluate the joint geometry and the clinical outcome of stemless, anatomical shoulder arthroplasty with the TESS system. METHODS: Twenty-one shoulders with a mean follow-up 18 of months were included. On scaled digital radiographs the premorbid center of rotation (CoR) was assessed and compared to the CoR of the prosthesis by using the MediCAD(®) software. Additionally, the pre- and post-operative geometry of the CoR was assessed in relation to the glenoid, the acromion as well as to the proximal humerus. Radiological changes, such as radiolucencies, were also assessed. Clinical outcome was assessed with the Constant and DASH score. RESULTS: Both, the Constant and DASH scores improved significantly from 11% to 75% and from 70 to 30 points, P < 0.01 respectively. There were no significant differences regarding age, etiology, cemented or metal-backed glenoids, etc. (P > 0.05). The pre- and postoperative humeral offset, the lateral glenohumeral offset, the height of the CoR, the acromiohumeral distance as well as neck-shaft angle showed no significant changes (P > 0.05). The mean deviation of the CoR of the prosthesis from the anatomic center was 1.0 ± 2.8 mm. Three cases showed a medial deviation of more than 3 mm. These deviations of 5.1, 5.7 and 7.6 mm and were caused by an inaccurate humeral neck cut. These 3 patients showed a relatively poor outcome scoring. CONCLUSION: TESS arthroplasty allows an anatomical joint reconstruction with a very good outcome. Outliers described in this study sensitize the surgeon for an accurate humeral neck cut. Baishideng Publishing Group Inc 2017-10-18 /pmc/articles/PMC5656495/ /pubmed/29094010 http://dx.doi.org/10.5312/wjo.v8.i10.790 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Observational Study
von Engelhardt, Lars V
Manzke, Michael
Breil-Wirth, Andreas
Filler, Timm J
Jerosch, Joerg
Restoration of the joint geometry and outcome after stemless TESS shoulder arthroplasty
title Restoration of the joint geometry and outcome after stemless TESS shoulder arthroplasty
title_full Restoration of the joint geometry and outcome after stemless TESS shoulder arthroplasty
title_fullStr Restoration of the joint geometry and outcome after stemless TESS shoulder arthroplasty
title_full_unstemmed Restoration of the joint geometry and outcome after stemless TESS shoulder arthroplasty
title_short Restoration of the joint geometry and outcome after stemless TESS shoulder arthroplasty
title_sort restoration of the joint geometry and outcome after stemless tess shoulder arthroplasty
topic Observational Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656495/
https://www.ncbi.nlm.nih.gov/pubmed/29094010
http://dx.doi.org/10.5312/wjo.v8.i10.790
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