scholarly journals Heterotopic Ossification of the Brachial Plexus After Reverse Total Shoulder Arthroplasty

2018 ◽  
Vol 2 ◽  
pp. 247154921880777 ◽  
Author(s):  
Patrick K Riggle ◽  
Brett G Brazier ◽  
C Luke Wilcox
Keyword(s):  
Brachial Plexus ◽  
Heterotopic Ossification ◽  
Shoulder Arthroplasty ◽  
Proximal Humerus Fracture ◽  
Axillary Artery ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Fracture Dislocation ◽  
Brachial Plexopathy ◽  
Reverse Total Shoulder

In the following report, we present the case of a patient who presented with a proximal humerus fracture dislocation and an associated brachial plexopathy. After undergoing a reverse total shoulder arthroplasty, the brachial plexopathy showed signs of improvement plateaued until the patient started having increased pain in the involved extremity and the brachial plexopathy began to worsen. At that time, it was discovered that the patient had heterotopic ossification (HO) encasing the brachial plexus and axillary artery. To our knowledge, this is the first reported case of HO involving the brachial plexus and axillary artery.

Exposure of the brachial plexus in complex revisions to reverse total shoulder arthroplasty

2019 ◽  
Vol 43 (12) ◽  
pp. 2789-2797 ◽  
Author(s):  
Jorge Rojas ◽  
Filippo Familiari ◽  
Amrut U. Borade ◽  
Jacob Joseph ◽  
E. Gene Deune ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder

Reassessing glenoid inclination in reverse total shoulder arthroplasty with glenosphere lateralization

2021 ◽  
Vol 103-B (2) ◽  
pp. 360-365
Author(s):  
Kuhan A. Mahendraraj ◽  
Maggie V. Shields ◽  
Florian Grubhofer ◽  
Samuel W. Golenbock ◽  
Andrew Jawa
Keyword(s):  
Heterotopic Ossification ◽  
Shoulder Arthroplasty ◽  
Patient Reported Outcomes ◽  
External Rotation ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Scapular Notching ◽  
Patient Reported ◽  
Reverse Total Shoulder

Aims Existing literature indicates that inferiorly inclined glenoid baseplates following reverse total shoulder arthroplasty (RSA) produce better outcomes compared to superiorly inclined baseplates. We aim to compare clinical outcomes for RSAs with superiorly and neutrally/inferiorly inclined lateralized glenospheres. Methods We retrospectively reviewed 154 consecutive patients undergoing RSA between July 2015 and July 2017 by one single-fellowship trained surgeon (AJ). Two raters (KAM and MVS) independently measured glenoid inclination in preoperative and minimum two year follow-up radiographs (anteroposterior/Grashey) using the RSA angle. Inclination was then compared to patient-reported outcomes, range of motion (ROM), and independently assessed degree of scapular notching and staging of heterotopic ossification at two year follow-up. Results Median postoperative inclination for each group was found to be -3.6° (interquartile range (IQR) -2.1 to -6.9) and 6.0° (3.2° to 10.1°) for the neutrally/inferiorly and superiorly inclined cohorts, respectively. Preoperative inclination was highly associated with postoperative inclination (p = 0.004). When comparing superiorly and neutrally/inferiorly inclined glenospheres, there were no differences in heterotopic ossification (p = 0.606), scapular notching (p = 0.367), American Shoulder and Elbow Surgeons score (p = 0.419), Single Assessment Numeric Evaluation (p = 0.417), Visual Analogue Scale (VAS) pain score (p = 0.290), forward elevation (p = 0.161), external rotation (p = 0.537), or internal rotation (p = 0.656). Conclusion Compared to neutral and inferior inclination, up to 6° ± 3° of superior glenoid baseplate inclination on a lateralized RSA design produces no differences in postoperative ROM or patient-reported outcomes, and produces similar levels of scapular notching and heterotopic ossification. Additionally, the degree of preoperative inclination represents an important factor in surgical decision-making as it is strongly associated with postoperative inclination. It is important to note that the findings of this study are only reflective of lateralized RSA prostheses. Cite this article: Bone Joint J 2021;103-B(2):360–365.

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