Short-Term Results of the DePuy Global Unite Platform Shoulder System: A Two-Year Outcome Study

Document Type: RESEARCH PAPER

Authors

The Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA

Abstract

Background: The Global Unite Shoulder System is the next generation of implant from the Depuy Global Shoulder
line. The primary feature of the Global Unite is adaptability through the interchangeable modular bodies, modular suture
collars, and stems. Short-term functional and radiographic outcomes of the Global Unite Platform Shoulder System
were assessed as well as complication and revision rates.
Methods: 95 subjects were enrolled prospectively between 2013 and 2015 that underwent anatomic or reverse
shoulder arthroplasty utilizing the DePuy Global Unite Anatomic Platform Shoulder System. Functional outcome data
(ASES and SANE) as well as radiographic data was collected on these patients pre-operatively, and at 6 months, 1
year and 2 years post-operatively.
Results: The cohort consisted of 97 shoulders in 95 patients of which 54 (56.8%) are males and 41 (43.2%) are female.
There were 55/97 (56.7%) were primary anatomic total shoulder arthroplasties, 37/97 (38.1%) primary reverse shoulder
arthroplasties, and 3/97 (3.1%) revision procedures to a reverse shoulder arthroplasty. Outcome scores demonstrated
an increase in ASES score from a mean of 33.00 to 79.56 and SANE score of 21.30 to 84.08.
Conclusion: The Depuy Global Unite shoulder system demonstrated very good short-term results in this two-year outcome
study. Functional outcome scores are similar to current literature for anatomic and reverse primary cases. Radiographic
measures at two years are promising with only 2 cases of grade 1 scapular notching and one case of grade 2 scapular
notching. Overall the Depuy Global Unite is a versatile shoulder system with very good early outcomes.
Level of evidence: IV

Keywords

Main Subjects


1. Lugli T. Artificial shoulder joint by péan (1893): the
facts of an exceptional intervention and the prosthetic
method. Clin Orthop Relat Res. 1978; 133:215-8.
2. Neer CS. Articular replacement for the humeral head.
J Bone Joint Surg Am. 1955; 37-A(2):215-28.
3. Neer CS 2nd, Watson KC, Stanton FJ. Recent experience
in total shoulder replacement. J Bone Joint Surg Am.
1982; 64(3):319-37.
4. Boileau P, Watkinson D, Hatzidakis AM, Hovorka I.
Neer Award 2005: The Grammont reverse shoulder
prosthesis: results in cuff tear arthritis, fracture
sequelae, and revision arthroplasty. J Shoulder Elbow
Surg. 2006; 15(5):527-40.
5. Boileau P, Watkinson DJ, Hatzidakis AM, Balg F.
Grammont reverse prosthesis: design, rationale, and
biomechanics. J Shoulder Elbow Surg. 2005; 14 (1
Suppl S): 147S-61S.
6. Williams AA, Tischler EH, Sholder D, Nicholson TA,
Maltenfort MG, Getz C, et al. Identification of risk
factors for abnormal postoperative chemistry labs
after primary shoulder arthroplasty. Arch Bone Jt
Surg. 2018; 6(4):282-8.
7. Favard L, Lautmann S, Clement P. Osteoarthritis with
massive rotator cuff-tear: the limitation of its current
definitions. Berlin, Heidelberg: Springer Berlin
Heidelberg; 1999. P. 261-5.
8. Hamada K, Fukuda H, Mikasa M, Kobayashi Y.
Roentgenographic findings in massive rotator cuff
tears. A long-term observation. Clin Orthop Relat Res.
1990; 254:92-6.
9. Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Molé
D. Grammont inverted total shoulder arthroplasty in
the treatment of glenohumeral osteoarthritis with
massive rupture of the cuff. Results of a multicentre
study of 80 shoulders. J Bone Joint Surg Br. 2004;
86(3):388-95.
10. Day JS, Lau E, Ong KL, Williams GR, Ramsey ML, Kurtz
SM. Prevalence and projections of total shoulder and
elbow arthroplasty in the United States to 2015. J
Shoulder Elbow Surg. 2010; 19(8):1115-20.
11. Wiater JM, Fabing MH. Shoulder arthroplasty:
prosthetic options and indications. J Am Acad Orthop
Surg. 2009; 17(7):415-25.
12. Deshmukh AV, Koris M, Zurakowski D, Thornhill TS.
Total shoulder arthroplasty: long-term survivorship,
functional outcome, and quality of life. J Shoulder

Elbow Surg. 2005; 14(5):471-9.
13. Nicholson T, Maltenfort M, Getz C, Lazarus M,
Williams G, Namdari S. Multimodal pain management
protocol versus patient controlled narcotic analgesia
for postoperative pain control after shoulder
arthroplasty. Arch Bone Jt Surg. 2018; 6(3):196-202.
14. Gerber C, Pennington SD, Nyffeler RW. Reverse total
shoulder arthroplasty. J Am Acad Orthop Surg. 2009;
17(5):284-95.
15. Gruber S, Schoch C, Geyer M. The reverse shoulder
arthroplasty Delta Xtend: Mid-term results.
Orthopade. 2017; 46(3):222-6.
16. Austin L, Zmistowski B, Chang ES, Williams GR
Jr. Is reverse shoulder arthroplasty a reasonable
alternative for revision arthroplasty? Clin Orthop
Relat Res. 2011; 469(9):2531-7.
17. Crosby LA, Wright TW, Yu S, Zuckerman JD.
Conversion to reverse total shoulder arthroplasty
with and without humeral stem retention: the role
of a convertible-platform stem. J Bone Joint Surg Am.
2017; 99(9):736-42.
18. Weinheimer KT, Smuin DM, Dhawan A. Patient
Outcomes as a function of shoulder surgeon
volume: a systematic review. Arthroscopy. 2017;
33(7):1273-81.