Revision of Reverse Total Shoulder Arthroplasty: Humeral Component

2020 ◽  
pp. 345-353
Author(s):  
Jean Kany
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Humeral Component ◽  
Reverse Total Shoulder

Complication and revision rates after reverse total shoulder revision from hemiarthroplasty: a systematic review

2021 ◽  
pp. 175857322110193
Author(s):  
Arjun K Reddy ◽  
Jake X Checketts ◽  
B Joshua Stephens ◽  
J Michael Anderson ◽  
Craig M Cooper ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Arthroplasty ◽  
Revisional Surgery ◽  
Total Shoulder Arthroplasty ◽  
Surgical Site Infections ◽  
Total Sample ◽  
Reverse Total Shoulder Arthroplasty ◽  
Common Complication ◽  
Humeral Component ◽  
Reverse Total Shoulder

Background Thus, the purpose of the present study was to (1) characterize common postoperative complications and (2) quantify the rates of revision in patients undergoing hemiarthroplasty to reverse total shoulder arthroplasty revisional surgery. We hypothesize that hardware loosenings will be the most common complication to occur in the sample, with the humeral component being the most common loosening. Methods This systematic review adhered to PRISMA reporting guideline. For our inclusion criteria, we included any study that contained intraoperative and/or postoperative complication data, and revision rates on patients who had undergone revision reverse total shoulder arthroplasty due to a failed hemiarthroplasty. Complications include neurologic injury, deep surgical site infections, hardware loosening/prosthetic instability, and postoperative fractures (acromion, glenoid, and humeral fractures). Results The study contained 22 studies that assessed complications from shoulders that had revision reverse total shoulder arthroplasty from a hemiarthroplasty, with a total sample of 925 shoulders. We found that the most common complication to occur was hardware loosenings (5.3%), and of the hardware loosenings, humeral loosenings (3.8%) were the most common. The revision rate was found to be 10.7%. Conclusion This systematic review found that revision reverse total shoulder arthroplasty for failed hemiarthroplasty has a high overall complication and reintervention rates, specifically for hardware loosening and revision rates.

Humeral component retroversion in reverse total shoulder arthroplasty: a biomechanical study

2012 ◽  
Vol 21 (9) ◽  
pp. 1121-1127 ◽  
Author(s):  
Lawrence V. Gulotta ◽  
Dan Choi ◽  
Patrick Marinello ◽  
Zakary Knutson ◽  
Joseph Lipman ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Biomechanical Study ◽  
Reverse Total Shoulder Arthroplasty ◽  
Humeral Component ◽  
Reverse Total Shoulder

scholarly journals Analysis of complications of reverse total shoulder arthroplasty

Joints ◽  
2015 ◽  
Vol 03 (02) ◽  
pp. 62-66 ◽  
Author(s):  
Raffaele Russo ◽  
Giuseppe Rotonda ◽  
Michele Ciccarelli ◽  
Fabio Cautiero
Keyword(s):  
Shoulder Arthroplasty ◽  
Constant Score ◽  
Total Shoulder Arthroplasty ◽  
Case Series ◽  
Reverse Total Shoulder Arthroplasty ◽  
Fracture Group ◽  
Long Thoracic Nerve ◽  
Secondary Osteoarthritis ◽  
Humeral Component ◽  
Reverse Total Shoulder

Purpose: the aim of this study was to analyze complications of reverse total shoulder arthroplasty (RTSA) used to treat different shoulder diseases. Methods: from March 2000 to March 2013, 195 RTSA were implanted by the senior Author. The indications for reverse prosthesis surgery were secondary osteoarthritis (OA) in 49 cases, irreparable rotator cuff tear (RCT) in 48 cases, and complex humeral fractures in 75 cases, while 19 were patients requiring surgical revision for first prosthesis implant. We used different prostheses with different designs. Results: the clinical and radiological results of all the patients were analyzed retrospectively at an average follow-up of 7 years. The cases were divided into four groups on the basis of the diagnosis and complications were classified as perioperative, postoperative, or late. The mean total Constant score improved from 28 to 69 points in the OA group; from 21 to 70.8 points in the irreparable RCT group, to 76.4 in the fracture group, and from 16.6 to 59.8 points in the revision group. Scapular notching was observed in 59 cases (30.2%). Thirty-three other complications (16.9%) were observed, namely: hematomas (n=3), instability of the humeral component (n=1), scapular spine fractures (n=2), ulnar nerve deficit (n=2), long thoracic nerve palsy (n=2), deep infections (n=2), periprosthetic fractures (n=6), glenoid fractures (n=2), implant loosening (n=2), anterior deltoid muscle deficiency (n=2) and periarticular heterotopic calcifications (n=9). Conclusions: the rates of complications, especially fractures, reported in the present study were lower than those reported in the current literature. Level of evidence: Level IV, therapeutic case series.

The incidence of radiographic aseptic loosening of the humeral component in reverse total shoulder arthroplasty

2015 ◽  
Vol 24 (10) ◽  
pp. 1555-1559 ◽  
Author(s):  
Gregory Gilot ◽  
Andres M. Alvarez-Pinzon ◽  
Thomas W. Wright ◽  
Pierre-Henri Flurin ◽  
Michael Krill ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Humeral Component ◽  
Reverse Total Shoulder

scholarly journals The influence of posture and scapulothoracic orientation on the choice of humeral component retrotorsion in reverse total shoulder arthroplasty

2020 ◽  
Vol 29 (10) ◽  
pp. 1992-2001
Author(s):  
Philipp Moroder ◽  
Doruk Akgün ◽  
Fabian Plachel ◽  
Alexander D.J. Baur ◽  
Paul Siegert
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Humeral Component ◽  
Reverse Total Shoulder

scholarly journals Medialized versus Lateralized Center of Rotation in Reverse Total Shoulder Arthroplasty: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (24) ◽  
pp. 5868
Author(s):  
Alessandra Berton ◽  
Lawrence Vicent Gulotta ◽  
Umile Giuseppe Longo ◽  
Sergio De Salvatore ◽  
Ilaria Piergentili ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
External Rotation ◽  
Meta Analysis ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Cochrane Central Register ◽  
Complication Rates ◽  
Center Of Rotation ◽  
Humeral Component ◽  
Reverse Total Shoulder

One of the original biomechanical principles of reverse total shoulder arthroplasty (RTSA) is medialization of the center of rotation (COR) relative to the native level of the glenoid. Several authors have proposed the lateralized center of rotation, which is characterized by a lateralized (L) glenoid and medialized (M) humeral component. The aim of this review is to compare the clinical and functional outcomes of COR in medialized (M-RTSA) and lateralized (L-RTSA) RTSA in patients with uniform indications and treatment through a meta-analysis. A PRISMA-guided literature search of PubMed, Medline, Embase, Scopus, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and Cochrane Clinical Answers was conducted from April to May 2021. Twenty-four studies were included in the qualitative synthesis, and 19 studies were included in the meta-analysis. Treatment with RTSA resulted in positive post-operative outcomes and low complication rates for both groups. Statistically relevant differences between L-RTSA group and M-RTSA group were found in post-operative improvement in external rotation with arm-at-side (20.4° and 8.3°, respectively), scapular notching rates (6.6% and 47.7%) and post-operative infection rates (1% and 7.7%). Both lateralized and medialized designs were shown to improve the postoperative outcomes. Nevertheless, a lateralized COR resulted in greater post-operative external rotation.

scholarly journals A technique for humeral prosthesis placement in reverse total shoulder arthroplasty for fracture

2018 ◽  
Vol 11 (6) ◽  
pp. 459-464
Author(s):  
Paul J Cagle ◽  
Wayne Reizner ◽  
Bradford O Parsons
Keyword(s):  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Clinical Results ◽  
Reverse Total Shoulder Arthroplasty ◽  
Stem Height ◽  
Humeral Component ◽  
Recent Trends ◽  
Reverse Total Shoulder ◽  
Stem Version

Recent trends have illustrated the benefits of treating displaced fractures of the proximal humerus with reverse total shoulder arthroplasty. Clinical results have demonstrated reliable restoration of function in situations where results following hemiarthroplasty have been variable and difficult to predict. Data have demonstrated landmarks to assist with humeral stem height in hemiarthroplasty. However, intraoperative landmarks to guide placement of the humeral component in reverse shoulder arthroplasty have not been described. In this technique, the superior border of the pectoralis tendon is utilized. A distance of 5.0 cm is used to assist in placement of the most superior aspect of the metallic humeral component and with humeral stem version. This technique can be used as a guide to assist a treating physician in situations where bony fracture and comminution make humeral stem height placement difficult to judge.

scholarly journals Patient-specific Guides Using 3-dimensional Reconstruction Provide Accuracy and Reproducibility in Reverse Total Shoulder Arthroplasty

2019 ◽  
Vol 22 (1) ◽  
pp. 16-23
Author(s):  
Jong Pil Yoon ◽  
Dong Hyun Kim ◽  
Jae Wook Jung ◽  
Chang-Hwa Lee ◽  
Seunggi Min ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Conventional Group ◽  
Patient Specific ◽  
Glenoid Component ◽  
3 Dimensional ◽  
Humeral Component ◽  
Dimensional Reconstruction ◽  
Reverse Total Shoulder

Background: We aimed to evaluate whether the use of our novel patient-specific guide (PSG) with 3-dimensional reconstruction in reverse total shoulder arthroplasty (RTSA) would allow accurate and reliable implantation of the glenoid and humeral components.Methods: 20 fresh-frozen cadaveric shoulders were used. The PSG group (n=10) and conventional group (n=10) was evaluated the accuracy and reproducibility of implant positioning between before and after surgery on the computed tomography image.Results: The superoinferior and anteroposterior offset in the glenoid component were 0.42 ± 0.07, 0.50 ± 0.08 in the conventional group and 0.45 ± 0.03, 0.46 ± 0.02 in the PSG group. The inclination and version angles were -1.93° ± 4.31°, 2.27° ± 5.91° and 0.46° ± 0.02°, 3.38° ± 2.79°. The standard deviation showed a smaller difference in the PSG group. The anteroposterior and lateromedial humeral canal center offset in the humeral component were 0.45 ± 0.12, 0.48 ± 0.15 in the conventional group and 0.46 ± 0.59 (<i>p</i>=0.794), 0.46 ± 0.06 (<i>p</i>=0.702) in the PSG group. The PSG showed significantly better humeral stem alignment.Conclusions: The use of PSGs with 3-dimensional reconstruction reduces variabilities in glenoid and humerus component positions and prevents extreme positioning errors in RTSA.

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