scholarly journals Correlation and responsiveness of global health, upper extremity-specific, and shoulder-specific functional outcome measures following reverse total shoulder arthroplasty for proximal humerus fracture

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
James Barger ◽  
Dafang Zhang ◽  
Derek S. Stenquist ◽  
Peter Ostergaard ◽  
Matthew Hall ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Global Health ◽  
Upper Extremity ◽  
Shoulder Arthroplasty ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Total Shoulder Arthroplasty ◽  
Ceiling Effects ◽  
Reverse Total Shoulder

Abstract Purpose Reverse total shoulder arthroplasty (rTSA) is effective and increasingly utilized for the management of proximal humerus fracture (PHF). However, the optimal patient-reported outcome metrics (PROMs) for the evaluation of patient outcomes after this surgery are unclear. We investigated the correlation among global, upper extremity-specific, and shoulder-specific PROMs in patients undergoing rTSA for PHF as well as the responsiveness of these PROMs as assessed by floor and ceiling effects. We hypothesized that patients’ post-operative outcome would be best reflected by a combination of these metrics. Methods Thirty patients with a history of rTSA for ipsilateral PHF filled out the following outcomes questionnaires at a minimum of 3 years post-op: EQ-5D, EQ-5D VAS, PROMIS physical function, DASH, SSV, SPADI, and ASES. Correlation between metrics was assessed using the Spearman correlation coefficient. Responsiveness was assessed by comparing the proportion of patients reaching floor or ceiling values using McNemar’s test. Results Global health metrics (EQ-5D and PROMIS physical function) were strongly correlated with the upper extremity-specific metric (DASH). Shoulder-specific outcomes (SPADI, ASES, and ASES) were moderately correlated with both the global metrics and DASH. There was no significant difference between PROMs with regards to floor and ceiling effects. Conclusions The DASH score has been shown to be valid and responsive for shoulder interventions, and our data demonstrate that it correlates strongly with overall quality of life. Shoulder-specific metrics are valid and responsive for shoulder interventions but correlate less with global quality of life. An optimal PROM strategy in rTSA for PHF might involve both DASH and a shoulder-specific score. Based on our assessment of floor and ceiling effects, none of these metrics should be excluded for poor responsiveness.

Biomechanics of Reverse Total Shoulder Arthroplasty

2013 ◽  
Author(s):  
Heath B. Henninger ◽  
Robert T. Burks ◽  
Robert Z. Tashjian
Keyword(s):  
Shoulder Arthroplasty ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Glenohumeral Joint ◽  
Total Shoulder Arthroplasty ◽  
Revision Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Functional Improvement ◽  
Glenoid Surface ◽  
Reverse Total Shoulder

Reverse total shoulder arthroplasty (rTSA) provides significant pain relief and functional improvement in patients with a deficient rotator cuff, 4-part proximal humerus fracture, inflammatory arthritis or revision arthroplasty.[1, 2] As a non-anatomic procedure, rTSA transposes the ball and socket in the glenohumeral joint, allowing the deltoid to initiate elevation of the arm, provide stability and minimize shear forces acting at the glenoid surface.[3, 4]

scholarly journals Clinically relevant results of reverse total shoulder arthroplasty for patients younger than 65 years compared to the older patients

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Klaus Hanisch ◽  
Michael Boelstoft Holte ◽  
Inge Hvass ◽  
Niels Wedderkopp
Keyword(s):  
Quality Of Life ◽  
Shoulder Arthroplasty ◽  
Older Patients ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Reverse Total Shoulder

Abstract Background Reverse total shoulder arthroplasty was originally designed for older patients with rotator cuff arthropathy and produces good results. The main objective of this retrospective study was to compare the patients younger than 65 years vs. the older patients in terms of the complications of reverse total shoulder arthroplasty and the functional recovery. Methods From January 2014 to January 2020, 566 patients who underwent the reverse total shoulder arthroplasty were divided into two groups (group A, ≥ 65 years, n = 506; group B, < 65 years, n = 60). The patients reported the quality of life using the patient-reported Western Ontario Osteoarthritis of the Shoulder index. The Constant score was obtained preoperatively and 3 months postoperatively. The complications and reoperations were compared. Statistical significance was set at P < 0.05. Results Clinically relevant improvements were found in group A and B. There was a multivariate statistically-significant but not clinically relevant difference in the change over time between group A and B. The mean 12-month Western Ontario Osteoarthritis of the Shoulder indexes were 58 in group B and 71 in group A. The mean Constant scores were 44 in group B vs. 43 in group A. Compared to group A, group B had a non-significant odds ratio of 1.9, which did not reach the clinically relevant Western Ontario Osteoarthritis of the Shoulder index of group A. Conclusion In patients younger than 65 years of age, RTSA seems to be a safe procedure in short term follow-up. After 1 year, we found no increased risk of complications, revision, or inferior outcomes compared to patients older than 65 years of age. Consequently, after one-year, RTSA provided clinically relevant improvements in the patients’ quality of life and shoulder strength regardless of age.

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