Glenohumeral arthrodesis outcomes and complications: a systematic review

Kwabena Adu-Kwarteng; Grant H Cabell; Eoghan T Hurley; Alaowei Y Amanah; Jay M Levin; Tally E Lassiter; Yaw D Boachie-Adjei; Christopher S Klifto; Oke Anakwenze

doi:10.1016/j.jse.2023.10.025

Glenohumeral arthrodesis outcomes and complications: a systematic review

J Shoulder Elbow Surg. 2023 Dec 15:S1058-2746(23)00852-2. doi: 10.1016/j.jse.2023.10.025. Online ahead of print.

Authors

Kwabena Adu-Kwarteng¹, Grant H Cabell², Eoghan T Hurley², Alaowei Y Amanah³, Jay M Levin², Tally E Lassiter², Yaw D Boachie-Adjei², Christopher S Klifto², Oke Anakwenze²

Affiliations

¹ School of Medicine, Duke University, Durham, NC, USA. Electronic address: Kwabena.adukwarteng@duke.edu.
² Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.
³ School of Medicine, Duke University, Durham, NC, USA.

PMID: 38104717
DOI: 10.1016/j.jse.2023.10.025

Abstract

Background: The purpose of this study was to systematically review the evidence in the literature to determine the clinical outcomes following glenohumeral arthrodesis.

Methods: 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.

Results: 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.

Conclusion: Shoulder arthrodesis provides improvement in functional outcomes for end-stage glenohumeral injuries; however, it is also associated with high rates of complications.

Keywords: Arthrodesis; arthroplasty; end stage; fusion; glenohumeral joint; shoulder; systematic review.

Publication types

Review