Short- to midterm outcomes following pyrocarbon glenohumeral hemiarthroplasty: a retrospective review.

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中文解读

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Original abstract

<h4>Background</h4>Glenohumeral osteoarthritis (GHOA) in young patients remains challenging due to high revision rates following arthroplasty in active individuals. The purpose of this study was to evaluate clinical outcomes and radiographic parameters following pyrocarbon (PyC) hemiarthroplasty (HA) in patients with GHOA.<h4>Methods</h4>A retrospective review was performed at a single academic institution from 2015 to 2025 including patients who underwent PyC HA with a minimum of one year of clinical and radiographic follow-up. Mean clinical and radiographic follow-up was 2.7 years (range, 1-7.5 years). Patient-reported outcome measures and range of motion (ROM) were recorded pre-operatively and at final follow-up. Glenoid morphology and erosion were assessed using the Walch, Sperling, and Goya classifications, along with critical shoulder angle (CSA), lateral glenohumeral offset (LGHO), humeral subluxation index, and circle method. A 2-tailed <i>t</i>-test evaluated differences between pre-operative and post-operative values with statistical significance set at <i>P</i> < .05. Normality of continuous variables was confirmed using the Mann-Whitney <i>U</i> test prior to further analysis.<h4>Results</h4>Twenty-seven shoulders in 26 patients were included (16 males; 10 females), with a mean age of 47.4 years. The mean radiographic follow-up was 2.7 years (range, 1-7.5). Glenoid resurfacing was performed in 6 patients (23.1%). There were no fractures, dislocations, or infections. Two patients (7.6%) required revision to reverse shoulder arthroplasty at a mean of 1.3 years due to rotator cuff pathology. Twelve patients (46.2%) were overstuffed. Glenoid erosion progressed in 12 patients (46.2%), 7 of whom were overstuffed (58.3%). Among patients with erosion progression, changes in CSA and LGHO were not statistically significant. Pre-operative and post-operative subluxation was noted in 26.9% (n = 7) and 19.2% (n = 5), respectively. Significant post-operative improvements were observed in American Shoulder and Elbow Surgeons (<i>P</i> = .029) and Single Assessment Numeric Evaluation (<i>P</i> = .001) scores. ROM improved in forward flexion (<i>P</i> = .040), abduction (<i>P</i> = .006), and external rotation (<i>P</i> = .040).<h4>Conclusion</h4>Patient satisfaction and ROM improved post-operatively following PyC HA. Revisions were related to rotator cuff pathology rather than glenoid erosion. CSA and LGHO did not significantly differ in patients with erosion progression, approximately half of whom were overstuffed. PyC HA remains a viable treatment option for GHOA in younger patients.

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