Objective: To investigate the clinical effects of arthroplasty with UNIVERS 3-D prosthesis, the representative of fourth generation of shoulder joint prosthesis proved to be more suitable to shoulder anatomy, in treatment of glenohumeral osteoarthritis.
Methods: Seventy-four patients with glenohumeral osteoarthritis, aged 67.07 (47 - 84), received shoulder arthroplasty with UNIVERS 3-D prosthesis and were followed up for 31.9 months (12 - 74 months). Roentgenography was conducted to observe the acromion, and acromion-humeral distance (AHD), glenohumeral distance (GHD), humerus height (HH), and humerus width (HW). Constant scoring and normalized Constant scoring were used to evaluate the function of the shoulder joint.
Results: The Constant score at the last follow-up was 68.40 +/- 16.91 points, significantly higher than that at beginning (34.094 +/- 15.00, P < 0.05), The normalized Constant score at the last follow-up was 92.27 +/- 22.53%, significantly higher than that at the beginning (45.29 +/- 19.87%, P < 0.05). The post-operative pain, daily life, activity score, and myodynamia scores were all significantly higher than those evaluated pre-operatively (all P < 0.05). Pre-operative roentgenography showed 93.47% of the cases with humeral head periarticular osteophytes located at the inferior side; 36.96% with humeral head necrosis; 8.69% with humeral head cyst; and 39.13% with periarticular osteophytes of glenoid, and showed that AHD was shortened (1.83 +/- 1.64 mm), and GHD, HH, and HW were all narrowed (10.91 +/- 3.03 mm; 5.71 +/- 4.32 mm, and 3.34 +/- 4.82 mm respectively). After the operation, the AHD, GHD, and HH were all significantly increased, and HW did not significantly changed. The humeral inclination angle was changed postoperatively from 126 degrees to 142 degrees. The incidence of radiolucent lines around the prosthesis of humeral shaft was 5.41%, most in the zones d, c, and e, all with the radiolucent index of less than 1. The overall complication rate was 12.2%.
Conclusion: Treatment of glenohumeral osteoarthritis with UNIVERS 3-D prosthesis effectively reconstructs the anatomy of glenohumeral joint, and shows excellent clinical results with low incidence of radiolucency and postoperative complications.