Pyrocarbon hemiprostheses show little glenoid erosion and good clinical function at 5.5 years of follow-up

The success of traditional shoulder hemiarthroplasty (HA) with cobalt-chromium heads is limited by painful glenoid erosion with problematic bone loss. Hemiprostheses with pyrolytic carbon (PyC) heads have shown reduced glenoid erosion in experimental laboratory studies. Few in vivo data are availabl...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2024-01, Vol.33 (1), p.55-64
Main Authors: Kleim, Benjamin D., Zolotar, Aleksei, Hinz, Maximilian, Nadjar, Rudolf, Siebenlist, Sebastian, Brunner, Ulrich H.
Format: Article
Language:English
Subjects:
Arthroplasty, Replacement, Shoulder
Chromium
Cobalt
Cohort Studies
Follow-Up Studies
glenohumeral arthritis
Glenoid Cavity - surgery
glenoid erosion
glenoid reaming
hemi-arthroplasty
Humans
Pain
Pyrocarbon
pyrolytic carbon
Range of Motion, Articular
Retrospective Studies
Shoulder arthroplasty
Shoulder Joint - diagnostic imaging
Shoulder Joint - surgery
Treatment Outcome
young
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Summary:The success of traditional shoulder hemiarthroplasty (HA) with cobalt-chromium heads is limited by painful glenoid erosion with problematic bone loss. Hemiprostheses with pyrolytic carbon (PyC) heads have shown reduced glenoid erosion in experimental laboratory studies. Few in vivo data are available. We performed a single-center consecutive cohort study of 31 of 34 patients (91%) who underwent PyC HA between September 2013 and June 2018. In 11 of these patients, concentric glenoid reaming was additionally performed. The mean follow-up period was 5.5 years (range, 3.5-7 years). Standardized radiographs were taken, and clinical function (Constant score) and pain (visual analog scale score) were recorded. Anteroposterior radiographs were analyzed according to an established method by 2 independent observers: A line parallel to the superior and inferior glenoid rim was translated to the most medial point of the glenoid surface. A further parallel line was placed on the spinoglenoid notch. The distance between these 2 lines was measured. Measurements were scaled using the known diameter of the implanted humeral head component. To assess eccentric erosion, anteroposterior and axial images were classified according to Favard and Walch, respectively. Mean medial glenoid erosion measured 1.4 mm at an average of 5.5 years of follow-up. In the first year, 0.8 mm of erosion was observed, significantly more than the average erosion per year of 0.3 mm (P 
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2023.05.027