Ultra-short Implant Outcome in Poor Bone Quality

Abstract Purpose Fractures of the acromion and the scapular spine are serious complications after reverse total shoulder arthroplasty. They concern about 4 to 5% of the patients and always result in a significant deterioration of shoulder function. Different causes have been taken into consideration, particularly stress or fatigue fractures. The purpose of the present study was to analyse our own cases and to discuss the causes reported in the literature. Methods We reviewed our shoulder arthroplasty registry and the consultation reports of the last ten years. The charts and radiographs of all patients who had a post-operative fracture of the acromion or the scapular spine were carefully examined and the results were compared with those of an age- and gender-matched control group. Results Twelve patients with an average age of 79 years sustained a fracture of the acromion (n = 6) or the scapular spine (n = 6). The time interval between the operation and the fracture averaged 26 months and ranged from three weeks to 70 months. Eight patients (67%) had a trauma. Seven of them reported a fall on the corresponding shoulder and one a heavy blow on the acromion. The four non-traumatic fractures were attributed to poor bone quality. All 12 patients had immediate pain and difficulty to actively elevate the affected arm. The time interval between the fracture and its diagnosis averaged ten weeks (0 to 10 months). At final follow-up, all patients could reach their face and refused further surgery. Two patients rated their result as good, six as acceptable and four as poor. Conclusions Our study cannot support the hypothesis that most acromion and scapular spine fractures after RSA are the result of increased tension in the deltoid or stress fractures. In our series, the majority of the fractures were related to a fall. Implantation of a reverse prosthesis exposes the acromion and makes it more vulnerable to direct trauma. Non-traumatic fractures were associated with poor bone quality.

Download Full-text

Osseotite® vs. machined surface in poor bone quality

Clinical Oral Implants Research ◽

10.1046/j.0905-7161.2003.00955.x ◽

2003 ◽

Vol 14 (6) ◽

pp. 703-708 ◽

Cited By ~ 31

Author(s):

Dietmar Weng ◽

Marianne Hoffmeyer ◽

Markus B. Hürzeler ◽

Ernst-Jürgen Richter

Keyword(s):

Bone Quality ◽

Poor Bone Quality ◽

Machined Surface

Download Full-text

How does short implant success rely on cortical bone quality?

10.26226/morressier.5efe04779b888de4950e776b ◽

2020 ◽

Author(s):

Igor Linetskiy

Keyword(s):

Cortical Bone ◽

Bone Quality ◽

Short Implant

Download Full-text

Results of limb reconstruction system in failed osteosynthesis of long bones

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20170010 ◽

2017 ◽

Vol 3 (2) ◽

pp. 287

Author(s):

Hiranya Kumar ◽

Siddalingeshwar Vithoba Honnur ◽

Manoj Kumar Shukla ◽

Srikanth Etikala Neruganti

Keyword(s):

Soft Tissue ◽

Bone Quality ◽

Bone Fractures ◽

Limb Length Discrepancy ◽

Limb Length ◽

Long Bones ◽

Poor Bone Quality ◽

Length Discrepancy ◽

Soft Tissue Problems ◽

Financial Issues

Background: The LRS is an excellent option treating the failed osteosynthesis in long bone fractures, because of failure in healing due to loosening of implant, infection, nonunion, poor bone quality and bone loss associated with deformities, limb length discrepancy, soft tissue problems, functional and financial issues.Methods: we prospectively treated 30 cases of failed osteosynthesis of long bones (7 plating, 22 nailing & 1 k-wire with plaster) between April 2009 to October 2015 with LRS. Initially we managed by implant removal, freshening of fracture site or radical debridement followed by LRS application.Results: Union occurred in 93% cases. The eradication of infection was seen in 96.5% cases. Average lengthening done was 4.2 cms. We had 93% excellent and 7 % poor bony result. Functional result was excellent in 45%, good in 48% and failure in 7% cases using ASAMI scoring system.Conclusions: LRS is an excellent option in the management of failed osteosynthesis especially associated with infection, nonunion, deformities, limb length discrepancy, soft tissue problems, functional and financial issues and also where re-osteosynthesis is challenging with poor bone quality and bone stock. It is simpler technically, patient friendly and short learning curve.

Download Full-text