scholarly journals Pre-Operative CT-Based Planning Integrated With Intra-Operative Navigation in Reverse Shoulder Arthroplasty: Data Acquisition and Analysis Protocol, and Preliminary Results of Navigated Versus Conventional Surgery

Dose-Response ◽  
2020 ◽  
Vol 18 (4) ◽  
pp. 155932582097083
Author(s):  
Fabio Moreschini ◽  
Giovanni Battista Colasanti ◽  
Carlo Cataldi ◽  
Lorenzo Mannelli ◽  
Nicola Mondanelli ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Conventional Technique ◽  
Shoulder Function ◽  
Glenoid Component ◽  
Navigation Group ◽  
Screw Length ◽  
Operative Planning ◽  
Glenoid Baseplate

Reverse total shoulder arthroplasty (RSA) successfully restores shoulder function in different conditions. Glenoid baseplate fixation and positioning seem to be the most important factors influencing RSA survival. When scapular anatomy is distorted (eccentric osteoarthrirtis, rotator cuff arthropathy), optimal baseplate positioning and secure screw purchase can be challenging. The aim of this study was to evaluate whether CT-based pre-operative planning, integrated with intra-operative navigation could improve glenoid baseplate fixation and positioning by increasing screw length, reducing number of screws required to obtain fixation and increasing the use of augmented baseplate to gain the desired positioning. Twenty patients who underwent navigated RSA were compared retrospectively with 20 patients operated on with a conventional technique. All the procedures were performed by the same surgeon, using the same implant. Mean screw length was significantly longer in the navigation group (35.5 ± 4.4 mm vs 29.9 ± 3.6 mm; p = .001). Significant higher rate of optimal fixation using 2 screws only (17 vs 3 cases, p = .019) and higher rate of augmented baseplate usage (13 vs 4 cases, p = .009) was also present in the navigation group. Pre-operative CT-based planning integrated with intra-operative navigation can improve glenoid component positioning and fixation, possibly leading to an improvement of RSA survival.

scholarly journals Study on glenoid component in anatomical total shoulder arthroplasty in Nagapattinam district

2021 ◽  
Vol 7 (2) ◽  
pp. 223
Author(s):  
A. Palanivel
Keyword(s):  
Outcome Measures ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Randomized Study ◽  
Shoulder Function ◽  
Glenoid Component ◽  
Screw Breakage ◽  
Pain At Rest

<p class="abstract"><strong>Background:</strong> Depending upon the mechanism of dysfunction or injury a shoulder arthroplasty can either be a partial or total replacement. Shoulder arthroplasty surgery has shown remarkable progress during the last few decades. The objective was to study the effect of prosthesis positioning in reverse shoulder arthroplasty on radiological and clinical outcomes.</p><p class="abstract"><strong>Methods:</strong> This was a prospective comparative non-randomized study of 37 patients who underwent reverse shoulder arthroplasty (RSA) in Government District Head Quarters Hospital Nagapattinam with a follow-up ranging from March 2018 to January 2019 (11 months).<strong></strong></p><p class="abstract"><strong>Results:</strong> Grade 1 indicated a notch limited to the scapular pillar, grade 2 reached the inferior screw of the baseplate, grade 3 extended beyond the inferior screw and grade 4 reached the central peg of the baseplate. Glenoid loosening was defined as radiolucencies under the baseplate or around the peg or screws, screw breakage, or glenoid migration.</p><p class="abstract"><strong>Conclusions:</strong> Outcome measures were improved regardless of the LHO. At 3 months follow-up increased LHO harmed shoulder function and gave more shoulder pain at rest and exertion but did not affect the quality of life, health status, or ROM. At 12 months follow-up, LHO had no relation with the outcome measures. Further studies are warranted to investigate the influence of LHO on long-term prosthetic survival.</p>

scholarly journals Journey of the glenoid in anatomic total shoulder replacement

2018 ◽  
Vol 11 (2) ◽  
pp. 140-148 ◽  
Author(s):  
Alessandro Castagna ◽  
Raffaele Garofalo
Keyword(s):  
Shoulder Arthroplasty ◽  
Current Practice ◽  
Total Shoulder Arthroplasty ◽  
Shoulder Function ◽  
Patient Specific ◽  
Glenoid Component ◽  
Shoulder Replacement ◽  
Final Destination ◽  
Component Loosening

Anatomic total shoulder arthroplasty (TSR) has been shown to generate good to excellent results for patients with osteoarthritis and a functioning rotator cuff. Many studies have reported that the glenoid component loosening and failure remain the most common long-term complication of total shoulder arthroplasty. The approach to glenoid component is critical because a surgeon should consider patient-specific anatomy, preserving bone stock and joint line restoration, for a good and durable shoulder function. Over the years, different glenoid design and materials have been tried in various configurations. These include cemented polyethylene, uncemented metal-backed and hybrid implants. Although advances in biomechanics, design and tribology have improved our understanding of the glenoid, the journey of the glenoid component in anatomic total shoulder arthroplasty has not yet reached its final destination. This article attempts to describe the evolution of the glenoid component in anatomic TSR and current practice.

scholarly journals Short-Term Outcomes of the Grammont Reverse Shoulder Arthroplasty: Comparison between First and Second Generation Delta Prosthesis

Joints ◽  
2021 ◽  
Author(s):  
Riccardo Luigi Alberio ◽  
Marco Landrino ◽  
Paolo Fornara ◽  
Federico Alberto Grassi
Keyword(s):  
Shoulder Arthroplasty ◽  
Second Generation ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Radiographic Evaluation ◽  
Glenoid Component ◽  
Consecutive Series ◽  
Short Term ◽  
Component Loosening

Abstract Purpose This article compares short-term outcomes of two series of patients, who underwent reverse total shoulder arthroplasty (RTSA) with two different implants, both based on Grammont's principles: the Delta III (D-3) and the Delta Xtend (D-XT) prostheses. Methods The D-3 group included a consecutive series of 26 patients (mean age 75 years), that were treated between 2000 and 2006; the D-XT group included a consecutive series of 31 patients (mean age 72.5 years), for a total of 33 implants performed between 2011 and 2015. In both groups the most common diagnoses were cuff tear arthropathy (18 and 22 shoulders, respectively) and malunion of proximal humerus fractures (3 and 5). All procedures were performed by the same surgeon. Constant–Murley score (CMS) was used to assess clinical and functional outcomes. Radiographic evaluation included the true anteroposterior and axillary views. Results Twenty-three patients of the D-3 group and 22 patients (24 shoulders) of the D-XT group were evaluated at a mean follow-up of 42 months (range 26–84) and 44 months (range 26–66), respectively. Four complications occurred in the D-3 group (1 partial deltoid detachment, 1 dislocation, and 2 glenoid component loosening), while one early postoperative infection occurred in the D-XT group. Increases in elevation and CMS between preoperative and postoperative period were observed in both groups; only the D-XT group showed a slight improvement in rotations. The incidence of scapular notching was significantly different between the two groups: 100% for D-3 and 22.2% for D-XT in patients with a minimum follow-up of 5 years. Conclusion Prosthetic design evolution and greater acquaintance with this surgery have undoubtedly led to an improvement in short-term outcomes with second generation implants of RTSA. Future studies will have to ascertain whether newer implants, relying on biomechanical solutions alternative to Grammont's original concept, might provide additional advantages and minimize drawbacks.

scholarly journals Glenoid Component Loosening in Anatomic Total Shoulder Arthroplasty: Association between Radiological Predictors and Clinical Parameters—An Observational Study

2021 ◽  
Vol 10 (2) ◽  
pp. 234
Author(s):  
Alexandra Grob ◽  
Florian Freislederer ◽  
Alex Marzel ◽  
Laurent Audigé ◽  
Hans-Kaspar Schwyzer ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Mixed Model ◽  
Constant Score ◽  
Total Shoulder Arthroplasty ◽  
Shoulder Function ◽  
Glenoid Component ◽  
Joint Gap ◽  
Acromiohumeral Distance ◽  
One Year ◽  
Component Loosening

The mechanisms of glenoid component loosening in anatomic total shoulder arthroplasty (aTSA) are still unclear, and it remains undetermined which specific radiographic features are associated with clinical outcomes. Patients with primary osteoarthritis who underwent aTSA with a stemless implant and a pegged glenoid between January 2011 and December 2016 were extracted from a local registry. Anteroposterior radiographs were evaluated at six, 12, 24 months, and five years post-TSA for lateral humeral offset (LHO), joint gap (JG), acromiohumeral distance (AHD), and radiolucency (modified Franklin score); 147 patients were included. Mixed-model linear regression was used. Both constant score (CS) and subjective shoulder value (SSV) markedly decreased at five years follow-up compared to one year (p < 0.001 for both). AHD, LHO, and JG all showed a consistent and statistically significant decline over time, with the joint gap decreasing by half. Consistently, smaller JG and AHD were correlated with lower SSV (p = 0.03 and p = 0.07, respectively). Massive loosening was associated with a 14.5 points lower SSV (p < 0.01). Finally, narrowing of the JG was significantly correlated with increased radiolucency (p < 0.001) and tended toward worse SSV (p = 0.06). In summary, radiographic parameters displaying medialization and cranialization after aTSA with a cemented pegged glenoid are useful predictors of impaired shoulder function.

scholarly journals TOTAL SHOULDER ARTHROPLASTY, AN OVERVIEW, INDICATINS AND PROSTHETIC OPTIONS

2020 ◽  
Vol 73 (9) ◽  
pp. 1870-1873
Author(s):  
Mateusz Wicha ◽  
Agnieszka Tomczyk-Warunek ◽  
Jaromir Jarecki ◽  
Anna Dubiel
Keyword(s):  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Shoulder Function ◽  
Long Term Result ◽  
Glenohumeral Osteoarthritis ◽  
Hip Arthroplasties ◽  
Reverse Total Shoulder

Shoulder arthroplasty (SA) has improved significantly over the last twenty years. It offers the effective treatment for patients with severe shoulder dysfunctions. The indications for this procedure have recently expanded tremendously. However, the most common are glenohumeral osteoarthritis, inflammatory shoulder arthropathies, rotator cuff-tear arthropathy, complex fractures of the proximal humerus and osteonecrosis of a humeral head. There is range of the procedures, such as resurfacing of humeral head, anatomic total shoulder arthroplasty, hemiarthroplasty and reverse shoulder arthroplasty. All of them could significantly improve patients quality of life. The outcomes of the shoulder arthroplasty are very satisfying in terms of pain relief and considerable improvements in shoulder function as well as in motion. However, this procedure is not so popular as knee or hip arthroplasties. The reasons for this phenomenon are not clear. The complication rate is considerably low. The most common are periprosthetic fractures, infections, implant loosening and instability. The reasonable solution is a conversion to reverse total shoulder arthroplasty. The survivorship of the prosthesis is up to 12 years, which is acceptable by patients. Long term result are still not clear. Surgeons performing SA opt for deltopectoral approach which provides good exposure of the joint also for revisions. The aim: To summarize knowledge about SA based on current literature.

scholarly journals Imaging of shoulder arthroplasties and their complications: a pictorial review

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Damien Combes ◽  
Romain Lancigu ◽  
Patrick Desbordes de Cepoy ◽  
Filippo Caporilli-Razza ◽  
Laurent Hubert ◽  
...  
Keyword(s):  
Joint Replacement ◽  
Shoulder Arthroplasty ◽  
Shoulder Joint ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Glenoid Component ◽  
Humeral Component ◽  
Number Of Patients ◽  
Component Loosening ◽  
Shoulder Arthroplasties

Abstract Currently, an increasing number of patients benefit from shoulder prosthesis implantation. Radiologists are therefore more often confronted with imaging examinations involving shoulder arthroplasty, whether during a dedicated examination or incidentally. Standard radiography is the first-line imaging modality in the follow-up of these implants, before the possible use of cross-sectional imaging modalities (computed tomography and magnetic resonance imaging), ultrasound, or nuclear medicine examinations. Shoulder arthroplasties are divided into three categories: reverse shoulder arthroplasty, total shoulder arthroplasty, and partial shoulder joint replacement (including humeral hemiarthroplasty and humeral head resurfacing arthroplasty). Each of these prostheses can present complications, either shared by all types of arthroplasty or specific to each. Infection, periprosthetic fractures, humeral component loosening, heterotopic ossification, implant failure, and nerve injury can affect all types of prostheses. Instability, scapular notching, and acromial fractures can be identified after reverse shoulder arthroplasty implantation. Glenoid component loosening and rotator cuff tear are specific complications of total shoulder arthroplasty. Progressive wear of the native glenoid is the only specific complication observed in partial shoulder joint replacement. Knowledge of different types of shoulder prostheses and their complications’ radiological signs is crucial for the radiologist to initiate prompt and adequate management.

scholarly journals Glenoid Failure after Total Shoulder Arthroplasty, cemented all-polyethylene versus metal-backed: A Systematic Review Protocol

2020 ◽  
Author(s):  
Renato Aroca Zan ◽  
Rafael Fuchs Lazarini ◽  
Fábio Teruo Matsunaga ◽  
Nicola Archetti Netto ◽  
João Carlos Belloti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Arthroplasty ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Total Shoulder Arthroplasty ◽  
Shoulder Function ◽  
Glenoid Component ◽  
Cochrane Central Register ◽  
Science Data ◽  
Functional Scores

Abstract BackgroundAnatomical Total Shoulder Arthroplasty (TSA) is an effective treatment adopted in patients with glenohumeral osteoarthritis. The glenoid component failure is the main risk that occurs in this therapeutic choice; however, doubts remain, regarding the selection of the best implant in order to avoid such complication.MethodsA systematic review of randomized clinical trials (RCTs) or quasi will be carried out, applying the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocols, comparing polyethylene (keeled and pegged) versus metal back implants in adult patients with glenohumeral osteoarthritis.Our search strategy will be carried out in the MEDLINE, PubMed, Cochrane Central Register of Controlled Trials, EMBASE, Web of Science. Data management and extraction will be performed using a data withdrawal form and by analyzing study method characteristics, participant characteristics, intervention characteristics, results, methodological domains. The summaries of research evidence will be accessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Shoulder function through functional scores such as Constant-Murley (CM) and American Shoulder and Elbow Surgeons (ASES), pain (Visual Analogue Scale), infection, procedure failure, radiograph radiolucency and loosening, are the selected outcomes. Another analysis such as subgroup, heterogeneity, sensitivity and statistical are going to be performed whenever possible.DiscussionThis systematic review aims to analyze how glenoidal implants behave in Total Shoulder Arthroplasties and therefore provide evidence concerning the best clinical practice to avoid complication. Systematic review registrationPROSPERO, CRD 42018079537.

scholarly journals Glenoid failure after total shoulder arthroplasty with cemented all-polyethylene versus metal-backed implants: a systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e043449
Author(s):  
Renato Aroca Aroca Zan ◽  
Rafael Fuchs Lazarini ◽  
Fabio Teruo Matsunaga ◽  
Nicola Archetti Netto ◽  
João Carlos Belloti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Arthroplasty ◽  
Meta Analysis ◽  
Total Shoulder Arthroplasty ◽  
Shoulder Function ◽  
Sensitivity Analyses ◽  
Glenoid Component ◽  
Cochrane Central Register ◽  
Functional Scores ◽  
Selection Of

IntroductionAnatomical total shoulder arthroplasty (TSA) is an effective treatment adopted for patients with glenohumeral osteoarthritis (OA). The glenoid component failure is the main risk that occurs in this therapeutic choice; however, doubts remain regarding the selection of the best implant for avoiding complication. This systematic review aims to evaluate the glenoid component in TSA by comparing the complications of different types of implants.Methods and analysisA systematic review of randomised clinical trials or quasi-randomised trials will be performed by applying the Preferred Reporting Items for Systematic Review and Meta-Analysis protocols and comparing polyethylene (keeled and pegged) versus metal-backed implants in adult patients with glenohumeral OA. Our search strategy will be performed using MEDLINE, PubMed, Cochrane Central Register of Controlled Trials, EMBASE and Web of Science. Data management and extraction will be performed using a data withdrawal form and by analysing study method characteristics, participant characteristics, intervention characteristics, results and methodological domains. The database search will be performed by February 2021. The Grading of Recommendations Assessment, Development and Evaluation will be used for assessing the quality of evidence of each study selected; however, some critical and important outcomes were determined such as the shoulder function through functional scores (Constant-Murley and American Shoulder and Elbow Surgeons), complications represented by pain (Visual Analogue Scale), surgical revision, radiograph radiolucency and loosening. The confidence in estimated effects for these outcomes will be applied as the overall confidence. The outcomes will be defined as early or late, according to the postoperative follow-up of less than or greater than 1 year, respectively, for complications and radiographs. For the shoulder function, follow-ups will be divided into 6, 12 and 24 months. Heterogeneity is expected in systematic reviews; therefore, the selection of outcomes, as well as the sample size, and specific statistical analysis can lead to meta-analysis; however, if it fails, narrative evidence synthesis will be conducted. Other analyses such as descriptive, subgroup and sensitivity analyses will be performed whenever possible. This systematic review will, therefore, provide evidence concerning the best clinical practice for avoiding complications.Ethics and disseminationThis study has been approved by the Institutional Review Board of Universidade Federal de São Paulo (protocols 0725/2017, 2.157.415 and 70473017.5.0000.5505), and the findings will be disseminated through peer-reviewed publication and conference presentations.PROSPERO registration numberCRD42018079537.

Sign in / Sign up

Export Citation Format

Share Document