Background: Reports of shoulder arthroplasty for the treatment of
fixed glenohumeral dislocation are rare. The purpose of this study was to
analyze the results following shoulder arthroplasty in patients with a fixed
anterior shoulder dislocation.
Methods: Eleven patients were evaluated at a minimum of twenty-four
months after they underwent an arthroplasty for the treatment of a fixed
anterior shoulder dislocation. Four patients underwent a total shoulder
arthroplasty, and the remainder were treated with a hemiarthroplasty. Four
shoulders had osseous reconstruction of the anterior aspect of the glenoid.
The patients were evaluated with use of the Constant score, measurement of
active anterior elevation and external rotation, the patient's subjective
grading of the result, and a radiographic examination.
Results: The mean Constant score improved from 21.1 points
preoperatively to 46.0 points following the arthroplasty, and the mean active
anterior elevation improved from 48.6° to 90.0°. The pain component of
the Constant score was the most reliably improved parameter, increasing from a
mean of 4.8 points preoperatively to a mean of 11.0 points postoperatively.
Eight patients reported that the result was excellent or good, and the
remaining three considered it to be fair. We observed seven complications in
five patients, including four cases of anterior instability of the shoulder.
Two of the four patients treated with a total shoulder replacement were seen
to have definite loosening of the glenoid component on follow-up
Conclusions: Shoulder arthroplasty in patients with a fixed anterior
shoulder dislocation is fraught with difficulties and complications. Although
arthroplasty reliably relieved shoulder pain in this population, limited
functional results should be expected.
Level of Evidence: Therapeutic Level IV. See Instructions
to Authors for a complete description of levels of evidence.