Radiographic and histopathologic analysis of osteolysis after total shoulder arthroplasty. Academic Article Article uri icon

Overview

MeSH

  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Osteoarthritis
  • Polyethylenes
  • Postoperative Complications
  • Prognosis
  • Prosthesis Design
  • Prosthesis Failure
  • Radiography
  • Retrospective Studies

MeSH Major

  • Arthroplasty, Replacement
  • Joint Prosthesis
  • Osteolysis
  • Shoulder Joint

abstract

  • This study analyzed clinical, radiographic, and histologic data from failed total shoulder arthroplasties (TSAs) to determine factors associated with osteolysis. From 1985 to 2005, 52 patients (mean age, 61.6 years) underwent revision TSA at a single institution at a mean of 4.3 years after their index surgery. Patients were retrospectively assigned to 2 cohorts based on the presence (n = 10) or absence (n = 42) of osteolysis around their implants on the last prerevision surgery radiographs. Clinical information, associated histopathology from tissues obtained at revision surgery, and polyethylene wear data from the retrieved glenoid components were compared between groups. In the osteolysis group, 20% had screw fixation compared with 2.5% without osteolysis (P = .039). The radiolucency score was significantly higher in the osteolysis group: 12.7 +/- 2.0 vs 8.7 +/- 3.7 (P = .003). Wear analysis of the osteolysis group demonstrated significant increases in third-body particles compared with those implants without osteolysis (P = .004). Histology available from retrieved implants demonstrated particulate debris in 62% of patients with osteolytic lesions vs 67% without osteolytic lesions (P > .05). Significant differences were found in patients with osteolytic lesions compared with patients undergoing TSA revision surgery without such lesions, specifically with regard to glenoids that used adjuvant screw fixation, the presence of increased radiolucent lines, and an abundance of third-body wear. No significant differences were found in particulate wear debris despite the prevailing notion that osteolysis is associated with particulate debris from implant wear. Screw fixation and third-body wear were associated with osteolysis after TSA. Copyright 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

publication date

  • June 2010

has subject area

  • Arthroplasty, Replacement
  • Follow-Up Studies
  • Humans
  • Joint Prosthesis
  • Middle Aged
  • Osteoarthritis
  • Osteolysis
  • Polyethylenes
  • Postoperative Complications
  • Prognosis
  • Prosthesis Design
  • Prosthesis Failure
  • Radiography
  • Retrospective Studies
  • Shoulder Joint

Research

keywords

  • Comparative Study
  • Journal Article

Identity

Language

  • eng

Digital Object Identifier (DOI)

  • 10.1016/j.jse.2009.09.012

PubMed ID

  • 20036583

Additional Document Info

start page

  • 588

end page

  • 595

volume

  • 19

number

  • 4