892 Dual Platform 4th Generation Shoulder Replacement System-Medium Term Results

Aim

To report medium term outcomes following 4th generation VAIOS® shoulder replacement.

Method

We retrospectively analysed prospectively collected data following VAIOS® shoulder arthroplasty performed by the senior author between 2014-2020. This included anatomical (TSR), reverse(rTSR), revision and trauma shoulder replacements. The primary outcome was implant survival (Kaplan-Meier analysis). Secondary outcomes were Oxford Shoulder Scores (OSS), radiological outcomes and complications.

Results

152 patients met our inclusion criteria with 114 rTSR and 38 anatomical TSR

Reverse TSR

Reverse TSR- 55 primary, 31 revisions, 28 for trauma.

Primary rTSR- 0 revisions, average 3.35-year follow-up.

Revision rTSR-1 revision (4.17%), average 3.52-year follow-up.

Trauma rTSR- 1 revision (3.57%), average 4.56-year follow-up

OSS: Average OSS improved from 15.39 to 33.8 (Primary rTSR) and from 15.11 to 29.1 (Revision rTSR). Trauma rTSR-Average post-operative OSS was 31.4.

Anatomical TSR

38 patients underwent primary anatomical TSR. In 16/38 patients, glenoid bone loss was addressed by bone grafting before implantation of the metal back glenoid component. Mean age at time of surgery was 68.3 years (53 – 81 years). Mean follow-up was 34 months (12 – 62 months). The average Oxford shoulder score improved from 14 (7-30) to 30 (9-48).

There were 3 revisions (7.8%); two following subscapularis failure requiring revision conversion to reverse shoulder replacement and one for glenoid graft failure.

Conclusions

The medium-term results of the VAIOS® system suggest much lower revision rates across multiple configurations of the system than previously reported, as well as a low incidence of scapular notching. This system allows conversion to rTSR during primary and revision surgery.