Semiconstrained total shoulder arthroplasty for glenohumeral arthritis and massive rotator cuff tearing

Each of 6 patients (7 shoulders) underwent semiconstrained total shoulder arthroplasty for glenohumeral arthritis, subluxation, and extensive rotator cuff tearing to obtain a more balanced joint and achieve consistent pain relief. A hooded glenoid component (Neer 600%) was used to contain the humeral head within the joint. Patients were followed for an average of 69 months (range, 26-125 months) or to revision surgery and were assessed clinically and radiographically. All patients experienced improvement with respect to pain; on average, active elevation and external rotation decreased to 44° and 43°. On radiographic evaluation, 3 of the glenoid components were seen to have complete radiolucent lines and 1 case showed a shift in component position. Five shoulders had anterior-superior joint subluxation. According to the shoulder score rating system of Neer, all but 1 of the shoulders were rated as unsatisfactory or unsuccessful at final follow-up. Two patients have undergone revision surgery for subluxation or glenoid loosening. We cannot recommend this method of treatment. (J Shoulder Elbow Surg 2000;9:302-7.)