PyroTITAN Pyrocarbon Shoulder Hemiarthroplasty: Clinical and Radiographic Outcomes with Medium-Term Follow-up.

BACKGROUND

Pyrocarbon hemiarthroplasty (HA) is a recent option for younger patients with end-stage glenohumeral joint (GHJ) arthritis. Early results are promising but limited by study bias. The aim of this study was to evaluate medium-term clinical and radiographic outcomes following PyroTITAN pyrocarbon HA.

METHODS

One hundred and nineteen shoulders with GHJ arthritis in 115 patients (mean age, 56.5 years; 92 shoulders were in male patients) underwent PyroTITAN pyrocarbon HA. Primary patient-reported outcome measures (PROMs) included the Western Ontario Osteoarthritis of the Shoulder Index and American Shoulder and Elbow Surgeons score. Clinicians assessed shoulder range of motion and abduction strength. PROMs and clinician evaluations were recorded preoperatively and at 6, 12, and 24 months and 5 years postoperatively. Postoperative complications were recorded, and radiographs were evaluated for glenoid erosion. Implant survival was calculated over the 5-year follow-up period. Data were analyzed on an intention-to-treat basis using linear mixed models for continuous data and Friedman analysis of variance for ordinal data. Kaplan-Meier analysis assessed revision-free survival. Significance was set at p < 0.05.

RESULTS

There was significant improvement in all PROMs and ranges of motion at 6, 12, and 24 months and 5 years postoperatively. Abduction strength was significantly improved at 24 months. Seven complications (5.9%) were recorded: ongoing pain (n = 2), stiffness (n = 2), pain and stiffness (n = 2), and implant fracture (n = 1). There were 3 revisions (2.5%) and thus a 97.5% five-year survival rate. Glenoid erosion increased slightly but not significantly over time.

CONCLUSIONS

The findings in our patient series support the PyroTITAN HA implant as a viable option for GHJ arthritis across a broad age range, including younger patients.

LEVEL OF EVIDENCE: Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.