Minimum 10-year Follow-up of Anatomic Total Shoulder Arthroplasty and Ream-and-Run Arthroplasty for Primary Glenohumeral Osteoarthritis.

BACKGROUND: Reports on long term outcomes and failures of shoulder arthroplasty are uncommon. The purpose of this study is to present minimum 10-year outcomes in consecutive patients undergoing ream-and-run and anatomic total shoulder arthroplasty (TSA) for primary glenohumeral arthritis.

METHODS: This study analyzed consecutive patients that had undergone a ream-and-run or TSA with minimum 10-year follow-up. Pain scores and Simple Shoulder Test (SST) values were obtained preoperatively and at a minimum of 10 years postoperatively via e-mail or mail-in response. Percentage of maximum possible improvement (%MPI) was also calculated.

RESULTS: Of 127 eligible patients, 63 (50%) responded to a 10-year survey. This included 34 patients undergoing ream-and-run arthroplasty and 29 patients undergoing TSA. The ream-and-run patients were significantly younger than the TSA patients (60 ± 7 vs 68 ± 8, p<0.001), predominantly male (97% vs 41%, p<0.001), and had a lower American Society of Anesthesiologists classification (p=0.018). In the ream-and run group, the mean pain score improved from a preoperative value of 6.5 ± 1.9 to 0.9 ± 1.3 (p < 0.001), and the mean SST score improved from 5.4 ± 2.4 to 10.3 ± 2.1 at 10-year follow-up (p < 0.001). Twenty-eight (82%) achieved an SST improvement above the MCID of 2.6. Four patients (12%) underwent single-stage exchange to another hemiarthroplasty, while 1 (3%) required manipulation under anesthesia. In the TSA group, the pain score improved from a preoperative value of 6.6 ± 2.2 to 1.2 ± 2.3 (p < 0.001), and the SST score improved from 3.8 ± 2.6 to 8.9 ± 2.6 at 10-year follow-up. (p < 0.001). Of the 29 patients who underwent a TSA, 27 (93%) achieved an SST improvement above the MCID of 1.6. No patient in the TSA group required reoperation.

CONCLUSION: While the characteristics of the patients differ between the two groups, excellent functional results can be obtained with the ream-and-run arthroplasty and total shoulder arthroplasty for glenohumeral osteoarthritis.