Do the radiological changes seen at mid term follow up of stemless shoulder prosthesis affect outcome?
BACKGROUND
The Eclipse® (Eclipse® is a trademark of Arthrex, Naples, Florida) stemless shoulder prosthesis offers the surgeon the advantage of bone stock preservation and at the same time avoids the drawbacks of a resurfacing arthroplasty. Previous studies have shown radiographic changes on serial follow up of the Eclipse prosthesis. This study attempts to assess the significance of these radiographic changes and effect of cuff related pathology on the mid-term outcome of the Eclipse prosthesis.


METHODS
Between July 2005 and October 2008, 29 shoulders underwent shoulder arthroplasty with the Eclipse prosthesis; 23 shoulders, (seven women and 16 men) were available for the final follow up. The range of motion, Constant Score; age adjusted Constant Score, Subjective Shoulder Value and radiographs were assessed at serial follow-ups.


RESULTS
Significant improvements were seen in the Constant Score (78.9 ±20.1) compared to pre-operative score (32.9 ±5.2); also forward elevation, abduction and external rotation improved to 142.9 ± 36.6 °, 135.2 ± 40.5 ° and 49.8 ± 21.9 ° at 72 months (p < 0.001). Radiolucent lines and localised osteopenia, did not statistically impact on the clinical outcome. Partial tears of the supraspinatus and subscapularis had a negative impact on the Subjective Shoulder Value (p < 0.05) Partial or complete tears of the subscapularis led to worse Constant Score on follow up (p < 0.05).


CONCLUSIONS
The presence of radiolucent lines or localised osteopenia does not influence the mid term clinical outcome. Pre -operative partial supraspinatus tears or tears of the subscapularis lead to an inferior outcome.
['Moursy|Mohamed|M|', 'Niks|Milan|M|', 'Kadavkolan|Aditya S|AS|', 'Lehmann|Lars J|LJ|']
D000368:Aged D019643:Arthroplasty, Replacement D005260:Female D005500:Follow-Up Studies D006801:Humans D008297:Male D008875:Middle Aged D010003:Osteoarthritis D011184:Postoperative Period D057234:Preoperative Period D016059:Range of Motion, Articular D017006:Rotator Cuff D000070636:Rotator Cuff Injuries D012785:Shoulder Joint D000072227:Shoulder Prosthesis D016896:Treatment Outcome
Eclipse prosthesis Shoulder arthroplasty Shoulder arthritis Stemless arthroplasty Total shoulder arthroplasty