Codd Casey M, Codd Timothy P
School of Public Health, Yale University, New Haven, CT, USA.
Department of Orthopaedics, University of Maryland Medical System, Baltimore, MD, USA.
J Shoulder Elbow Surg. 2025 Aug;34(8):1926-1932. doi: 10.1016/j.jse.2024.11.018. Epub 2025 Jan 9.
Anatomic total shoulder arthroplasty (aTSA) are highly successful procedures for treatment of glenohumeral arthritis to reduce pain, improve range of motion, and overall quality of life. However, the long-term survivorship of the implant systems is less widely documented in the existing literature. The purpose of this study was to establish the long-term patient outcomes and identify factors influencing the postoperative implant survivorship of total anatomic shoulder arthroplasty devices/procedures utilizing the short-stemmed prosthesis and hybrid glenoid components of the Comprehensive Shoulder System (Zimmer Biomet, Warsaw, IN, USA) at an average of ten years.
Between 2007 and 2015, 159 shoulders in 128 unique patients were sequentially enrolled in the prospective, observational study following their aTSA utilizing the Zimmer Biomet Comprehensive Shoulder System with the mini stem component and modular hybrid glenoid component variation. Enrolled patients were clinically evaluated on an annual basis following their operation for up to ten years including a physical exam, radiographic evaluation, and patient outcomes via a modified Constant score and satisfaction.
The implant survival rate was 98.1% at ten years. The mean patient age was 70.4 ± 8.3 years (range: 50.7-90.3 years) at the time of surgery. Average Constant scores improved from preoperative to 6 months postoperative with an average of 81.55 ± 16.10 and 84.09 ± 15.12, respectively; however, there was a statistically significant longitudinal decline in Constant score with increasing age for an average loss of 0.5 points per year. The overall revision rate for this cohort was 1.26% for a total of 2 revision cases secondary to external trauma and not implant system related.
aTSA with the Comprehensive Shoulder System had a high survivorship rate at the 10-year follow-up with improved clinical results postoperative. Patients had comparable long-term clinical results to the current longitudinal literature regarding survivorship of other implant systems.
解剖型全肩关节置换术（aTSA）是治疗盂肱关节炎以减轻疼痛、改善活动范围和整体生活质量的非常成功的手术。然而，现有文献中对植入系统的长期生存率记录较少。本研究的目的是确定长期患者预后，并识别平均随访十年时，使用综合肩部系统（美国印第安纳州华沙市的捷迈邦美公司）的短柄假体和混合式关节盂组件的全解剖型肩关节置换器械/手术的术后植入物生存率的影响因素。
在2007年至2015年期间，128例独特患者的159个肩部在采用捷迈邦美综合肩部系统的短柄组件和模块化混合式关节盂组件进行aTSA后，依次纳入前瞻性观察研究。入组患者术后每年接受临床评估，长达十年，包括体格检查、影像学评估以及通过改良的Constant评分和满意度评估患者预后。
十年时植入物生存率为98.1%。手术时患者平均年龄为70.4±8.3岁（范围：50.7 - 90.3岁）。平均Constant评分从术前到术后6个月有所改善，分别平均为81.55±16.10和84.09±15.12；然而，随着年龄增长，Constant评分在统计学上有显著的纵向下降，平均每年下降0.5分。该队列的总体翻修率为1.26%，共有2例翻修病例，继发于外部创伤，与植入系统无关。
使用综合肩部系统的aTSA在10年随访时具有较高的生存率，术后临床结果有所改善。患者在长期临床结果方面与目前关于其他植入系统生存率的纵向文献相当。
