Glenohumeral arthrodesis outcomes and complications: a systematic review

The purpose of this study was to systematically review the evidence in the literature to determine the clinical outcomes following glenohumeral arthrodesis. Two independent reviewers performed a literature search in the PubMed database based on Preferred Reporting Items for Systematic Reviews and Me...

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Published in:Journal of shoulder and elbow surgery 2024-06, Vol.33 (6), p.1418-1424
Main Authors: Adu-Kwarteng, Kwabena, Cabell, Grant H., Hurley, Eoghan T., Amanah, Alaowei Y., Levin, Jay M., Lassiter, Tally E., Boachie-Adjei, Yaw D., Klifto, Christopher S., Anakwenze, Oke
Format: Article
Language:English
Subjects:
Aged
Arthrodesis
Arthrodesis - adverse effects
Arthrodesis - methods
arthroplasty
end stage
fusion
glenohumeral joint
Humans
Male
Postoperative Complications - epidemiology
Range of Motion, Articular
shoulder
Shoulder Joint - physiopathology
Shoulder Joint - surgery
systematic review
Treatment Outcome
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Summary:The purpose of this study was to systematically review the evidence in the literature to determine the clinical outcomes following glenohumeral arthrodesis. Two independent reviewers performed a literature search in the PubMed database based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies were included if they reported on outcomes following shoulder arthrodesis from the years of 2000-2022. Functional outcomes that were collected included the Subjective Shoulder Value, American Shoulder and Elbow Surgeons shoulder index score, visual analog scale pain score, and Oxford Shoulder Score. Range-of-motion data were also collected. This review included 17 studies, with a total of 316 patients, that met the inclusion criteria. The majority of the patients were male (67.4%), and the average age was 38.4 years (range, 7-82 years). The overall fusion rate was 88.7%, and the time to fusion was on average, 3.9 months (range, 2-8 months). Shoulder arthrodesis resulted in improvement in each of the functional outcomes assessed: Subjective Shoulder Value (preoperatively, 18.8; postoperatively, 43.9; and percent change, 132.8%), American Shoulder and Elbow Surgeons shoulder index score (postoperatively, 62.1), visual analog scale pain score (preoperatively, 8.5; postoperatively, 3.03; and percent change, 62.4%), and Oxford Shoulder Score (preoperatively, 9.4; postoperatively, 30.9; and percent change, 328.7%). The abduction, forward flexion, external rotation, and internal rotation range-of-motion measurements postoperatively were 57°, 64°, 3°, and 48°, respectively. Complications were reported in 33.6% of patients, with fractures (20.9%) and infections (18.6%) being the most common sources of complication. Shoulder arthrodesis provides improvement in functional outcomes for end-stage glenohumeral injuries; however, it is also associated with high rates of complications.
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2023.10.025