Early clinical results following staged bilateral primary total shoulder arthroplasty

• Published in: Journal of shoulder and elbow surgery Vol. 19; no. 1; pp. 137 - 142
• Main Authors: Gruson, Konrad I., MD, Pillai, Gita, Vanadurongwan, Bavornat, MD, Parsons, Bradford O., MD, Flatow, Evan L., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 2010; Elsevier
• Subjects: Aged; Aged, 80 and over; Arthroplasty, Replacement - adverse effects; Arthroplasty, Replacement - methods; Biological and medical sciences; Chi-Square Distribution; Cohort Studies; Diseases of the osteoarticular system; Female; Follow-Up Studies; Humans; Length of Stay; Male; Medical sciences; Middle Aged; Orthopedics; Pain Measurement; Patient Satisfaction; Postoperative Complications - physiopathology; Probability; Radiography; Range of Motion, Articular - physiology; Recovery of Function; Retrospective Studies; Risk Assessment; Shoulder Joint - diagnostic imaging; Shoulder Joint - pathology; Shoulder Joint - surgery; Shoulder Pain - diagnostic imaging; Shoulder Pain - surgery; Time Factors; Treatment Outcome; Bilateral; Rheumatology; Total shoulder arthroplasty
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2009.04.005

Background The advantages of performing either a single- or 2-staged joint replacement has been reviewed extensively in the hip and knee arthroplasty literature, but far less data exist regarding total shoulder replacements. In the appropriate clinical setting, bilateral total shoulder arthroplasty yields excellent functional results with a low complication profile. Materials and methods We evaluated retrospectively the records of 13 consecutive patients (26 shoulders) who underwent staged bilateral primary total shoulder replacements by a single surgeon, with a minimum follow-up of 12 months for each side (range, 12.0-61.5). The interval between replacements averaged 7.4 months (range, 0.5-26.0). Results The mean unadjusted baseline Constant score for the first versus the second side was not significant (35 vs 41, P = .3). These scores improved to 73 and 72 by final follow-up (both P < .0001). Mean pain scores on the visual analog scale (VAS) improved from 6.9 to 0.9 ( P < .0001). We found no difference in the estimated blood loss (EBL), operative time, or hospital length of stay (LOS) between the sides. Significantly higher mean scores were demonstrated in all components of the SF-36 questionnaire over a normalized cohort of U.S. age-matched males and females by final follow-up. All patients were satisfied with both procedures. Conclusion Staged, bilateral total shoulder arthroplasty results in excellent functional outcomes and high satisfaction in subjective patient assessment. We currently recommend a minimum of 6 weeks between replacements to allow for appropriate tissue healing and rehabilitation. Level of Evidence 4.