Patients Undergoing Anatomic Total Shoulder Arthroplasty Achieve Clinically Significant Outcomes Faster than those Undergoing Reverse Shoulder Arthroplasty

2021 ◽  
Author(s):  
Justin Drager ◽  
Evan M. Polce ◽  
Michael Fu ◽  
Michael Nemsick ◽  
Hailey P. Huddleston ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Clinically Significant

Complication rate and implant survival for reverse shoulder arthroplasty versus total shoulder arthroplasty: results during the initial 2 years

2016 ◽  
Vol 25 (6) ◽  
pp. 927-935 ◽  
Author(s):  
Diego Villacis ◽  
Lakshmanan Sivasundaram ◽  
William C. Pannell ◽  
Nathanael Heckmann ◽  
Reza Omid ◽  
...  
Keyword(s):  
Complication Rate ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Implant Survival

Glenoid bone grafting in primary anatomic total shoulder arthroplasty: a systematic review

2020 ◽  
pp. 175857322091765
Author(s):  
Betty Zhang ◽  
Gavinn Niroopan ◽  
Chetan Gohal ◽  
Bashar Alolabi ◽  
Timothy Leroux ◽  
...  
Keyword(s):  
Bone Loss ◽  
Shoulder Arthroplasty ◽  
Bone Grafting ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Level Of Evidence ◽  
Total Shoulder Arthroplasties ◽  
Component Loosening ◽  
Shoulder Arthroplasties

Background Primary anatomic total shoulder arthroplasty can be challenging in patients with complex glenoid wear patterns and bone loss. Severe retroversion (>15°) or significant bone loss may require bone grafting. This review summarizes the rate of revision and long-term outcomes of anatomic total shoulder arthroplasty with bone graft. Methods A systematic search of MEDLINE, Embase, PubMed, and CENTRAL databases was conducted from the date of inception to 23 October 2018. Two reviewers independently screened articles for eligibility and extracted data for analysis. The primary outcome was rate of revision. The secondary outcomes were rate of component loosening, functional outcome, and range of motion. Results Of the 1056 articles identified in the search, 26 underwent full-text screening and 7 articles were included in the analysis. All procedures were one-stage anatomic total shoulder arthroplasties. The rate of revision was 5.4% with component loosening and infection listed as indications over a weighted mean follow-up period of 6.3 years. Complications occurred in 12.6% of patients. Conclusion Glenoid bone grafting in anatomic total shoulder arthroplasty results in comparable revision rates and improvement in pain compared to augmented glenoid components and reverse shoulder arthroplasty. Due to the low quality of evidence, further prospective studies should be conducted. Level of evidence IV

Anatomic versus reverse shoulder arthroplasty: a mid-term follow-up comparison

2020 ◽  
pp. 175857322092115
Author(s):  
Bradley S Schoch ◽  
Joseph J King ◽  
Joseph Zuckerman ◽  
Thomas W Wright ◽  
Chris Roche ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Patient Reported Outcomes ◽  
External Rotation ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reoperation Rate ◽  
Patient Reported ◽  
Total Shoulder Arthroplasties ◽  
Shoulder Arthroplasties

Background Anatomic total shoulder arthroplasty improves pain and function with a reported reoperation rate of approximately 1% per year. With improved glenoid fixation, reverse shoulder arthroplasty implants may outperform anatomic total shoulder arthroplasty. We evaluate the functional outcomes and reoperation rate of anatomic total shoulder arthroplasty versus reverse shoulder arthroplasty at a minimum eight-year follow-up or revision. Methods Between 2005 and 2010, 187 shoulders (137 anatomic total shoulder arthroplasty, 50 reverse shoulder arthroplasty) were retrospectively reviewed at a mean of 8.8 years. The mean age at surgery was 67 years. Females were more commonly treated with reverse shoulder arthroplasty. Both groups had similar body mass index and comorbidities. Outcome measures evaluated included abduction, forward elevation, external rotation, internal rotation, Simple Shoulder Test, Constant score, American Shoulder and Elbow Score, University of California Los Angeles Shoulder score, and Shoulder Pain and Disability Index. Results At follow-up, anatomic total shoulder arthroplasty demonstrated greater overhead range of motion and external rotation. All patient-reported outcomes remained similar between groups. Reverse shoulder arthroplasty patients were more likely to rate shoulders as much better or better after surgery (90% versus 67%, p = 0.004). Complications were observed in 24% of anatomic total shoulder arthroplasties and 8% of reverse shoulder arthroplasties (p = 0.02). Reoperation was more common in anatomic total shoulder arthroplasties (23% versus 4%, p = 0.003). Discussion At mid-to-long-term follow-up, reverse shoulder arthroplasties demonstrated significantly fewer complications and reoperations than anatomic total shoulder arthroplasties. Despite similar patient-reported outcomes, reverse shoulder arthroplasty patients were more likely to be satisfied with their shoulder.

scholarly journals Causes of acromion and scapular spine fractures following reverse shoulder arthroplasty: a retrospective analysis and literature review

2020 ◽  
Vol 44 (12) ◽  
pp. 2673-2681
Author(s):  
Richard W. Nyffeler ◽  
Bartu Altioklar ◽  
Philipp Bissig
Keyword(s):  
Bone Quality ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Control Group ◽  
Time Interval ◽  
Spine Fractures ◽  
Poor Bone Quality ◽  
Significant Deterioration ◽  
Scapular Spine

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.

Anatomic total shoulder arthroplasty in rheumatoid arthritis: A systematic review

2020 ◽  
pp. 175857322095415
Author(s):  
Ahmed Haleem ◽  
Ajaykumar Shanmugaraj ◽  
Nolan S. Horner ◽  
Timothy Leroux ◽  
Moin Khan ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
Constant Score ◽  
Total Shoulder Arthroplasty ◽  
Significant Heterogeneity ◽  
Tissue Quality ◽  
Patient Reported ◽  
Clinically Significant ◽  
Reverse Total Shoulder

Purpose Given the poor soft-tissue quality in rheumatoid arthritis patients, many believe that rheumatoid arthritis should be treated with reverse total shoulder arthroplasty (rTSA). The purpose of this paper is to systematically assess outcomes of anatomic total shoulder arthroplasty (aTSA) in rheumatoid arthritis to determine if aTSA remains a viable option. Methods A comprehensive literature search was conducted identifying articles relevant to aTSA in the setting of rheumatoid arthritis with intact rotator cuff. Outcomes include clinical outcomes and rates of complication and revision. Results Ten studies were included with a total of 279 shoulders with mean follow-up of 116 ± 69 months. The mean age was 68 ± 10 years. Survivorship was 97%, 97% and 89% at 5, 10 and 20 years, respectively. The overall complication rate was 9%. Radiolucency was present in 69% of patients, of which 34% were at risk of loosening at 79 months. The overall rate of revision was 8.4%. Studies generally reported clinically significant improvements in range of motion, Constant score and ASES score. Conclusion aTSA in the rheumatoid patient results in improvements in range of motion and patient-reported outcomes. Rates of complications and survivorship are generally good in this population. However, it should be noted that there is significant heterogeneity in outcome reporting amongst the literature on this topic and that many studies fail to adequately report complication and revision rates. When compared to rTSA in patients with rheumatoid arthritis, evidence suggests that aTSA is still a viable treatment option despite the shift in utilization to rTSA.

Glenoid loosening and failure in anatomical total shoulder arthroplasty: is revision with a reverse shoulder arthroplasty a reliable option?

2012 ◽  
Vol 21 (3) ◽  
pp. 342-349 ◽  
Author(s):  
Barbara Melis ◽  
Nicolas Bonnevialle ◽  
Lionel Neyton ◽  
Christophe Lévigne ◽  
Luc Favard ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Glenoid Loosening

scholarly journals Treatment Effects of Reverse Total Shoulder Arthroplasty – A Simple Method to Measure Outcomes at 6, 12, 24 and 60 Months for Each Patient

2020 ◽  
Author(s):  
Joerg Huber ◽  
Ulrich Irlenbusch ◽  
Max J Kääb ◽  
Falk Reuther ◽  
Georges Kohut ◽  
...  
Keyword(s):  
Treatment Effect ◽  
Shoulder Arthroplasty ◽  
Treatment Effects ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
P Value ◽  
Simple Method ◽  
The Mean ◽  
Grade 3 ◽  
Dominant Side

Abstract Background Although shoulder arthroplasty is less common than knee or hip arthroplasty, the number of procedures being performed is increasing rapidly. The treatment effect is a simple method to measure outcome of joint replacement. The method was applied to measure results of total hip/knee arthroplasty but not yet for shoulder arthroplasty. Methods Included were patients with unilateral cuff arthropathy (Hamada grades >=2) treated with reversed total shoulder arthroplasty (RSA) in this prospective multicenter study. The patients were assessed with the ASES questionnaire. The treatment effects (TE) was calculated for each patient. TE = score reduction/baseline score. A positive TE means amelioration, TE = 0 unchanged, and a negative TE means worse. The primary aim was to calculate the TE’s for RSA at 6, 12, 24, and 60 months postoperatively. The secondary aim was to analyze the influence of confounders (preoperative Hamada grade, age, gender, dominance, side of the affected shoulder, general co-morbidities measured using ASA grade). Results 203 patients were included for this analysis of whom 183 patients had a complete 2 year follow up. Two years postoperatively the mean ASES score augmented significant from 20.5 to 78.7 (p<0.001). The 2 year TE's ranged from 1 to 0.09. We had no patient with a negative TE. A higher Hamada grade was associated with better TE’s (Hamada grade 4+ vs. 2, p-value 0.042). For age and dominant side there were weak associations where those aged 80+ and dominant side had better TE’s. The patients with higher ASA grade had lower TE’s (ASA grade 4+ vs. 1, p-value 0.013). The mean TE’s were 0.77 at 6-months, 0.81 at 1 year, 0.76 at 2 years and 0.73 at 5 years. Conclusions The outcome for reverse shoulder arthroplasty can be measured with the treatment effect method; the 2 years TE's vary from 1 to 0.09. The mean treatment effects change little in the first five postoperative years (from 0.73 to 0.81). The confounders for better TE’s were: higher severity of cuff arthropathy (Hamada grade 3, 4 and 5), less co-morbidities (ASA Grade 1), higher age (80+) and dominant side. Gender did not influence the 2-year TE’s. Trial registration: Comité intercantonal d'éthique (Jura, Fribourg, Neuchâtel), number 01/2008, 24.09.2008

Sign in / Sign up

Export Citation Format

Share Document