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Shoulder arthroplasty after prior anterior shoulder instability surgery: a matched cohort analysis

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the effect of prior anterior shoulder instability surgery (SIS) on the outcomes and complications of primary anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA).

Methods

Between 2007 and 2018, 38 primary total shoulder arthroplasties (TSA) (22 aTSA and 16 rTSA) with a prior SIS and a minimum of 2 years of follow-up were identified. This cohort was matched 1:3 based on age, sex, body mass index, year of surgery, and dominant shoulder. aTSA and rTSA were matched to patients with primary osteoarthritis (OA) and rotator cuff tear arthropathy (CTA), respectively.

Results

TSA produced similar postoperative pain, ROM, patient-reported outcome measures, complications, and revisions in those with prior SIS vs. controls. aTSA with prior SIS demonstrated worse final postoperative abduction (116° vs. 133°; P = 0.046) and abduction improvement (24° vs. 47°; P = 0.034) compared to OA controls. Both aTSA and rTSA with prior SIS demonstrated significant improvements from baseline across all metrics, with no significant differences between the groups. aTSA and rTSA with prior SIS demonstrated no differences to controls in complications (4.6% vs. 6.1%; P = .786 and 0% vs. 6.3%. P = .183) or revisions (4.6% vs. 4.6%; P = .999 and 0% vs. 4.2%; P = .279).

Conclusions

TSA after prior SIS surgery can improve both pain and function without adversely increasing the rates of complications or revision surgery. When compared to patients without prior SIS, aTSA demonstrated worse abduction; however, all other functional differences remained statistically similar.

Level of Evidence

III; Retrospective Cohort Comparison; Treatment Study.

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Funding

This investigation received no outside funding.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA

    Erick M. Marigi, Matthew M. Crowe & Bradley S. Schoch

  2. Exactech Inc., Gainesville, FL, USA

    Carl Tams

  3. Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USA

    Joseph J. King & Thomas W. Wright

  4. Department of Orthopedic Surgery, Hopital Ambroise Paré, Boulogne-Billancourt, France

    Jean-David Werthel

  5. Department of Orthopaedics, Medical University of South Carolina, Charleston, SC, USA

    Josef K. Eichinger & Richard J. Friedman

Authors
  1. Erick M. Marigi
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  2. Carl Tams
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  3. Joseph J. King
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  4. Matthew M. Crowe
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  5. Jean-David Werthel
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  6. Josef K. Eichinger
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  7. Thomas W. Wright
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  8. Richard J. Friedman
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  9. Bradley S. Schoch
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Corresponding author

Correspondence to Bradley S. Schoch.

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Conflict of interest

Marigi and Crowe have no financial, non-financial, or other conflicts of interests. Tams: financial—Employee Exactech; non-financial—none. King: financial—Paid Consultant Exactech, LinkBio Corp.; non-financial—none. Werthel: financial—Royalties FH Orthopedics Inc.; Paid Consultant Zimmer Biomet; non-financial—none. Eichinger: Paid Consultant FH Orthopedics, Flexion Therapeutics; Research Support Johnson & Johnson; Stock or Stock Options JPS; non-financial—none. Wright: financial—Royalties Exactech, Wolters Kluwer Health—Lippincott Williams and Wilkins; Paid consultant Exactech; non-financial—none. Friedman: Paid Consultant, Royalties, Research support Exactech Inc.; non-financial—none. Schoch: financial—Paid Consultant Exactech, Innomed; Royalties Exactech, Responsive Arthroscopy; non-financial—none.

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Marigi, E.M., Tams, C., King, J.J. et al. Shoulder arthroplasty after prior anterior shoulder instability surgery: a matched cohort analysis. Eur J Orthop Surg Traumatol 33, 961–969 (2023). https://doi.org/10.1007/s00590-022-03233-y

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  • DOI: https://doi.org/10.1007/s00590-022-03233-y

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