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INTRODUCTION
Glenohumeral arthrodesis is a rare salvage procedure for selected
patients with different shoulder pathologies. Among a variety of
surgical techniques, compression screws or plate fixation are most
widely used. Minimally invasive screw fixation has become more
popular, although it has been shown to be biomechanically inferior
to plate arthrodesis.
HYPOTHESIS
Screw arthrodesis would lead to a higher revision rate than plate
arthrodesis.
MATERIAL AND METHODS
Twenty-seven plate and 7 screw arthrodesis of the glenohumeral joint
in 19 male and 15 female patients of a mean age of 50years (range,
16-85years) were reviewed in a retrospective multicenter study with
at a follow-up of 43months (range, 11-152months) to compare their
clinical and radiographic outcome with special focus on revision
rate.
RESULTS
Constant score did not change, but its subscore for pain
significantly improved from 4.5 points (range, 0-15 points) to 11
points (range, 6-15 points). The subjective shoulder value increased
significantly from 19% (range, 0-70%) to 41% (range, 10-80%) and 81%
of the patients were satisfied. In 14 patients (41%), the
arthrodesis had to be revised either for non-union (11) or malunion
(3) at a mean of 12months (range, 0-47months). The 2 groups did not
differ in terms of demographic data, nor of preoperative and
postoperative clinical data. There were more revisions after screw
than plate fixation. If revision was performed for non-union, this
difference was significant.
DISCUSSION/CONCLUSION
In selected patients, glenohumeral arthrodesis can significantly
reduce pain and achieve at best a reasonable function and subjective
satisfaction rate. Revision rates favor plate over isolated screw
fixation.
LEVEL OF EVIDENCE
IV retrospective series.
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