• J Shoulder Elbow Surg · Sep 2018

    Arthroplasty for glenohumeral arthritis in shoulders with a previous Bristow or Latarjet procedure.

    • Laurent B Willemot, Bassem T Elhassan, John W Sperling, Robert H Cofield, and Joaquin Sánchez-Sotelo.
    • Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
    • J Shoulder Elbow Surg. 2018 Sep 1; 27 (9): 1607-1613.

    BackgroundCoracoid transfer has become increasingly popular for recurrent anterior shoulder instability. Despite the success, glenohumeral arthropathy develops in some patients. Arthroplasty in this population is complicated by altered anatomy, scarring, and retained hardware. This study evaluated shoulder arthroplasty in patients with a previous Latarjet or Bristow procedure.MethodsBetween 1980 and 2014, 33 patients underwent shoulder arthroplasty after coracoid transfer. Of these, 17 men and 13 women were monitored for a minimum of 2 years or until reoperation. Arthroplasty procedures included hemiarthroplasty (HA) in 5, total shoulder arthroplasty (TSA) in 14, and reverse shoulder arthroplasty (RTSA) in 11. Outcome measures included pain, range of motion, complications, and reoperations.ResultsAt the most recent follow-up, pain had significantly improved in all arthroplasty groups. Elevation and external rotation also improved significantly (P < .001). Overall, 9 shoulders (30%) underwent revision for instability (1 TSA and 1 HA), glenoid loosening (1 TSA), instability and glenoid loosening (3 TSA), late cuff failure (1 TSA), and painful glenoid erosion (2 HA). Revision rates were significantly different between HA and RTSA (P = .0058) and between TSA and RTSA (P = .015). Radiographically, 2 additional anatomic glenoid components were considered loose, progressive medial erosion was seen in 1 HA, and grade 1 to 2 notching was observed in 2 RTSAs.ConclusionsShoulder arthroplasty in patients after prior coracoid transfer is technically challenging, yet improvements in pain and function are predictable. Instability and glenoid loosening are common reasons for revision surgery, likely related to difficulties in achieving a good soft tissue balance.Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

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