CORR Insights®: Patient Posture Affects Simulated ROM in Reverse Total Shoulder Arthroplasty: A Modeling Study Using Preoperative Planning Software

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Edward G. McFarland
10.29007/hcd6 ◽  
2019 ◽  
Author(s):  
Alexander Greene ◽  
Sandrine Polakovic ◽  
Christopher Roche ◽  
Yifei Dai

Placement of the glenoid component in reverse total shoulder arthroplasty (rTSA) is of paramount importance and can affect a patient’s range of motion postoperatively. Preoperative planning and computer assisted surgery (CAS) can improve upon glenoid placement, but such systems for rTSA have experienced limited commercial success. Postoperative surgical reports from the first 1702 clinical cases of a commercially available CAS rTSA system were collected and analyzed for implant selection, implant placement, and incision start to incision close operative time, and compared to similar date cohorts for non-navigated cases. Navigated rTSA cases had a significantly longer incision time than non-navigated cases. Augmented glenoid components were used in a much higher percentage of navigated cases than non-navigated cases, suggesting that augmented glenoid components provide utility for correcting pathologic glenoid wear. The average resultant version and inclination of the implanted component increased with the size of augment used, suggesting there may not be a clear consensus on optimal version or inclination. Long term clinical follow up will need to be collected to determine if preoperative planning combined with more precise and accurate glenoid component positioning leads to improved clinical outcomes and implant longevity.


2021 ◽  
pp. 175857322110193
Author(s):  
Arjun K Reddy ◽  
Jake X Checketts ◽  
B Joshua Stephens ◽  
J Michael Anderson ◽  
Craig M Cooper ◽  
...  

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.


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