Purpose To determine whether lesser tuberosity osteotomy (LTO) and mini-stem humeral components (MSHCs) can be safely and effectively used together in total and hemi-shoulder arthroplasty (TSA/HHA). Methods This is a retrospective review of consecutive patients who underwent anatomic TSA/HHA utilizing combined LTO/MSHC with minimum 2-year follow-up. Six-week and final radiographs, range of motion, pain scores, and selected outcome measures were assessed. Results Seventy five shoulders with mean follow-up of 27.8 months (24–50 months) were analyzed. Sixty-seven (89.3%) shoulders had uneventful LTO healing. There were five (6.67%) LTO failures, one (1.33%) fibrous union, and two (2.67%) osteotomies that had displaced > 4 mm at 6 weeks; four of the five failures required open repair, including one converted to reverse TSA. The other failure, the fibrous union, and the two displaced osteotomies were without clinical deficits and elected for non-operative management. One patient required intraoperative conversion to a long stem due to concern that metaphyseal bone integrity was compromised, in part, by the LTO. Four (5.33%) stems subsided, with one of them also being frankly loose and requiring revision, while the other three were asymptomatic, not requiring treatment. No other stems were judged to be loose. Mean ASES, SANE, VAS, forward flexion, external rotation, and
MUSCULOSKELETAL SURGERY – Springer Journals
Published: Jun 1, 2018
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