Comparing revision rates and survival of pyrocarbon and non-pyrocarbon heads in total shoulder and hemi-shoulder arthroplasty

• Published in: Journal of shoulder and elbow surgery 2024-09
• Main Authors: Douven, Dirk P.M., Geijsen, Gert-Jan P., van Kampen, Paulien M., Heijnen, Stefan A.F., van Dijck, Robbert, van Eijk, Floor, Engelsma, Yde, Huijsmans, Pol
• Format: Article
• Language: English
• Subjects: Hemi-shoulder arthroplasty; humeral head; pyrocarbon; revision; survival; total shoulder arthroplasty
• ISSN: 1058-2746; 1532-6500; 1532-6500
• DOI: 10.1016/j.jse.2024.07.028

This retrospective, observational study aimed to assess the revision rates and survival curves in total shoulder arthroplasty (TSA) and hemi-shoulder arthroplasty (HSA) patients, including a subanalysis to investigate the impact of a pyrocarbon humeral head in revision rates. Data collected from 7 surgeons who performed primary HSA in 92 patients and primary TSA in 508 patients at a large private clinic were analyzed. The study focused on revision rates and identified factors leading to revisions, including rotator cuff insufficiency, dislocation, aseptic loosening, implant material, and glenoid erosion. The overall revision rate for HSA was found to be significantly higher (7.6%) than that for TSA (1.2%), with a maximum follow-up of 7 years. Subanalysis within the HSA group revealed a notably higher revision rate in cases involving a metal head (cobalt-chrome or titanium) (12.8%) than those with a pyrocarbon head (2.3%). This study underscores the importance of distinguishing between TSA and HSA when evaluating shoulder arthroplasty outcomes. The significantly higher revision rate in HSA, particularly with metal heads, suggests the need for careful consideration of implant selection to optimize long-term success in shoulder arthroplasty procedures.