Clinical Outcomes of Anatomical Total Shoulder Arthroplasty in a Young, Active Population

Nicholas Kusnezov, John C. Dunn, Stephen Arthur Parada, Kelly Kilcoyne, Brian R. Waterman

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Glenohumeral arthritis in young, active patients poses many treatment challenges, and significant concerns about component loosening and failure limit the available surgical options. We conducted a study of the clinical outcomes of total shoulder arthroplasty (TSA) for glenohumeral arthritis in a young, high-demand population. We searched the Military Health System Management Analysis and Reporting Tool database to retrospectively review the cases of all US military service members who had undergone anatomical TSA (Current Procedural Terminology code 23472) between 2007 and 2014. Demographic information, occupational parameters, and clinical outcomes were extracted from electronic medical records. Twenty-four service members (26 shoulders) met the inclusion criteria. The cohort was predominantly male (n = 25). Mean age was 45.8 years (range, 35-54 years). The most common etiology of glenohumeral arthritis was post-instability arthropathy (50.0%). At mean follow-up of 41 months, 9 patients had a total of 12 complications (46.2%), including 6 component failures caused by neurologic injury (2 cases), adhesive capsulitis (2), and venous thrombosis (2). The reoperation rate for all component failures was 23.1% (6 cases, 5 patients). Ten patients (41.7%) remained on active duty at 2 years, and 5 (20.8%) were subsequently deployed. Ultimately, 9 patients (37.5%) underwent medical discharge for persistent shoulder disability. TSA in young, active patients provides reliable improvements in range of motion and pain. However, roughly one-third of patients in this study were unable to continue high-demand activities by 2 years after surgery. The short-term complication profile (46.2%) and reoperation rate for component failure (23.1%) should be emphasized during preoperative counseling.

Original languageEnglish (US)
Pages (from-to)E273-E282
JournalAmerican journal of orthopedics (Belle Mead, N.J.)
Volume45
Issue number5
StatePublished - Jul 1 2016

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Arthroplasty
Population
Arthritis
Reoperation
Current Procedural Terminology
Nervous System Trauma
Bursitis
Joint Diseases
Electronic Health Records
Articular Range of Motion
Venous Thrombosis
Counseling
Demography
Outcome Assessment (Health Care)
Databases
Pain
Health

ASJC Scopus subject areas

  • Medicine(all)

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Clinical Outcomes of Anatomical Total Shoulder Arthroplasty in a Young, Active Population. / Kusnezov, Nicholas; Dunn, John C.; Parada, Stephen Arthur; Kilcoyne, Kelly; Waterman, Brian R.

In: American journal of orthopedics (Belle Mead, N.J.), Vol. 45, No. 5, 01.07.2016, p. E273-E282.

Research output: Contribution to journalArticle

Kusnezov, Nicholas ; Dunn, John C. ; Parada, Stephen Arthur ; Kilcoyne, Kelly ; Waterman, Brian R. / Clinical Outcomes of Anatomical Total Shoulder Arthroplasty in a Young, Active Population. In: American journal of orthopedics (Belle Mead, N.J.). 2016 ; Vol. 45, No. 5. pp. E273-E282.
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