PMID- 36727972
OWN - NLM
STAT- MEDLINE
DCOM- 20230407
LR  - 20230714
IS  - 1535-1386 (Electronic)
IS  - 0021-9355 (Linking)
VI  - 105
IP  - 7
DP  - 2023 Apr 5
TI  - Comparison of Humeral-Head Replacement with Glenoid-Reaming Arthroplasty (Ream 
      and Run) Versus Anatomic Total Shoulder Arthroplasty: A Matched-Cohort Study.
PG  - 509-517
LID - 10.2106/JBJS.22.00650 [doi]
AB  - BACKGROUND: Glenoid component failure is a major concern after anatomic total 
      shoulder arthroplasty (aTSA). Ream and run (RnR) is an alternative procedure that 
      may avoid glenoid-related complications. The purpose of this study was to compare 
      outcomes of RnR versus aTSA in younger patients with advanced glenohumeral 
      osteoarthritis. METHODS: This was a retrospective matched-cohort study of 110 
      patients who underwent aTSA and 57 patients who underwent RnR; patients were <66 
      years of age and had a minimum of 2 years of follow-up. Propensity matching was 
      performed using 21 preoperative variables. Pre- and postoperative 
      patient-reported outcome measures (PROMs) and health-related quality-of-life 
      (HRQoL) scores, satisfaction with outcome, and revision data were analyzed. 
      Mixed-effects models examined the association of preoperative variables with 
      outcomes. RESULTS: Thirty-nine patient pairs were matched. All patients were 
      male, with a mean age of 58.6 +/- 7.3 years and a mean follow-up 4.4 +/- 2.3 years. 
      The aTSA cohort had better final Simple Shoulder Test (SST) and American Shoulder 
      and Elbow Surgeons (ASES) scores. However, in the mixed-effects model analysis, 
      arthroplasty type was not associated with outcome. At 2 years postoperatively, a 
      significantly greater percentage of aTSA patients achieved the substantial 
      clinical benefit (SCB) for the ASES (100% versus 79.2%; p = 0.01) and the minimal 
      clinically important difference (MCID) (89.7% versus 75%; p = 0.02) for the 
      visual analog scale (VAS) for pain. At >5-year follow-up, there were no 
      significant differences between the cohorts in the percentage who achieved the 
      MCID, SCB, or patient acceptable symptom state (PASS) for the ASES, SST, and VAS 
      for pain. Three patients underwent revision arthroplasty for pain after RnR, at a 
      mean of 1.9 +/- 1.7 years. Two patients underwent revision arthroplasty for glenoid 
      loosening at 9.2 and 14 years after aTSA. CONCLUSIONS: RnR and aTSA had 
      comparable outcomes in most analyses. The greater early revision rate after RnR 
      should focus attention on optimizing patient selection and postoperative 
      management. Revision for glenoid loosening is a concern among younger and active 
      patients. Longer-term study is needed to better understand the relative benefits 
      and disadvantages of these procedures. LEVEL OF EVIDENCE: Therapeutic Level III . 
      See Instructions for Authors for a complete description of levels of evidence.
CI  - Copyright (c) 2023 by The Journal of Bone and Joint Surgery, Incorporated.
FAU - Levins, James
AU  - Levins J
AUID- ORCID: 0000-0003-3022-6900
AD  - Division of Shoulder and Elbow Surgery, Warren Alpert Medical School of Brown 
      University, Providence, Rhode Island.
FAU - Molla, Vadim
AU  - Molla V
AUID- ORCID: 0000-0001-8004-0624
FAU - Adkins, Jacob
AU  - Adkins J
AUID- ORCID: 0000-0002-5560-0367
FAU - Molino, Janine
AU  - Molino J
AUID- ORCID: 0000-0002-6258-3913
FAU - Pasarelli, Emily
AU  - Pasarelli E
FAU - Paxton, E Scott
AU  - Paxton ES
AUID- ORCID: 0000-0003-0795-4918
FAU - Green, Andrew
AU  - Green A
AUID- ORCID: 0000-0003-4599-2915
LA  - eng
PT  - Journal Article
DEP - 20230119
PL  - United States
TA  - J Bone Joint Surg Am
JT  - The Journal of bone and joint surgery. American volume
JID - 0014030
SB  - IM
CIN - J Bone Joint Surg Am. 2023 Apr 5;105(7):e21. PMID: 37017618
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Aged
MH  - Female
MH  - *Arthroplasty, Replacement, Shoulder/adverse effects
MH  - *Shoulder Joint/surgery
MH  - Cohort Studies
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Humerus/surgery
MH  - Range of Motion, Articular
COIS- Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided 
      with the online version of the article ( http://links.lww.com/JBJS/H400 ).
EDAT- 2023/02/03 06:00
MHDA- 2023/04/07 10:18
CRDT- 2023/02/02 08:04
PHST- 2023/04/07 10:18 [medline]
PHST- 2023/02/03 06:00 [pubmed]
PHST- 2023/02/02 08:04 [entrez]
AID - 00004623-202304050-00002 [pii]
AID - 10.2106/JBJS.22.00650 [doi]
PST - ppublish
SO  - J Bone Joint Surg Am. 2023 Apr 5;105(7):509-517. doi: 10.2106/JBJS.22.00650. Epub 
      2023 Jan 19.