Correlation Between Implant Positioning and Functional Outcomes in Partial Shoulder Resurfacing

Abstract

Objective The present study aimed to correlate functional outcomes and implant positioning in a case series of partial shoulder resurfacing arthroplasties.

Methods A total of 25 patients were assessed for range of motion, functional outcome per the University of California at Los Angeles (UCLA) score and radiographic findings. Pre- and postoperative data were compared. In addition, patients were grouped according to the cervical-diaphyseal angle (CDA) determined by an anteroposterior radiography and to the retroversion angle (RVA) determined by an axillary radiography. A CDA from 130° to 140° and a RVA from 20° to 40° consisted in ideal positioning (anatomical standard). Data were analyzed using the Wilcoxon signed-rank test, analysis of variance (ANOVA) followed by the Kruskal-Wallis test or the Mann-Whitney test as appropriate.

Results The mean follow-up time was 48.3 months (12 to 67 months). The postoperative functional score (31.5) was higher than the preoperative score (15.5) (p < 0.001). In 6 patients, the implant was in anatomical positioning, while implant positioning was considered “nonstandard” in 19 subjects. Seven patients had a CDA < 130°, and 14 patients had a CDA ranging from 130° to 140°; in addition, the CDA was > 140° in 4 subjects. The RVA was up to 20° in 15 patients and ranged from 20° to 40° in 10 subjects. Using these criteria to group patients, the postoperative clinical-functional parameters were not statistically different from the preoperative findings (p > 0.05).

Conclusion Partial shoulder resurfacing results in significant postoperative functional recovery in patients with degenerative joint diseases. However, implant positioning assessed by CDA and RVA does not correlate with clinical-functional outcomes and, therefore, it is an inaccurate indicator of surgical success.

Level of Evidence IV; Case Series.

Keywords

arthroplasty, replacement, shoulder - shoulder joint - shoulder prosthesis - prosthesis design

Financial Support

The present study received no financial support from public, commercial, or not-for-profit sources.

The present study was developed at the Shoulder and Elbow Surgery Center (CCOC, in the Portuguese acronym), Instituto Nacional de Traumatologia e Ortopedia (INTO, in the Portuguese acronym), Rio de Janeiro, RJ, Brazil.

Publication History

Received: 29 July 2020

Accepted: 08 January 2021

Article published online:
11 March 2022

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