Evaluation of Humeral Stem and Glenosphere Fixation in Reverse Total Shoulder Arthroplasty: A Prospective, Randomized Clinical Trial With Two-Year Follow-Up

OrthoMedia ◽  
2022 ◽  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Prospective Randomized Clinical Trial ◽  
Reverse Total Shoulder

Five-year outcome after conversion of a hemiarthroplasty when used for the treatment of a proximal humeral fracture to a reverse total shoulder arthroplasty

2018 ◽  
Vol 100-B (6) ◽  
pp. 761-766 ◽  
Author(s):  
M. Holschen ◽  
M-K. Siemes ◽  
K-A. Witt ◽  
J. Steinbeck
Keyword(s):  
Shoulder Arthroplasty ◽  
Proximal Humeral Fracture ◽  
Constant Score ◽  
Total Shoulder Arthroplasty ◽  
Operating Time ◽  
Humeral Fracture ◽  
Reverse Total Shoulder Arthroplasty ◽  
The Mean ◽  
Reverse Total Shoulder

Aims The reasons for failure of a hemirthroplasty (HA) when used to treat a proximal humeral fracture include displaced or necrotic tuberosities, insufficient metaphyseal bone-stock, and rotator cuff tears. Reverse total shoulder arthroplasty (rTSA) is often the only remaining form of treatment in these patients. The aim of this study was to evaluate the clinical outcome after conversions from a failed HA to rTSA. Material and Methods A total of 35 patients, in whom a HA, as treatment for a fracture of the proximal humerus, had failed, underwent conversion to a rTSA. A total of 28 were available for follow-up at a mean of 61 months (37 to 91), having been initially reviewed at a mean of 20 months (12 to 36) postoperatively. Having a convertible design, the humeral stem could be preserved in nine patients. The stem was removed in the other 19 patients and a conventional rTSA was implanted. At final follow-up, patients were assessed using the American Shoulder and Elbow Surgeons (ASES) score, the Constant Score, and plain radiographs. Results At final follow-up, the mean ASES was 59 (25 to 97) and the mean adjusted Constant Score was 63% (23% to 109%). Both improved significantly (p < 0.001). The mean forward flexion was 104° (50° to 155°) and mean abduction was 98° (60° to 140°). Nine patients (32%) had a complication; two had an infection and instability, respectively; three had a scapular fracture; and one patient each had delayed wound healing and symptomatic loosening. If implants could be converted to a rTSA without removal of the stem, the operating time was shorter (82 minutes versus 102 minutes; p = 0.018). Conclusion After failure of a HA in the treatment of a proximal humeral fracture, conversion to a rTSA may achieve pain relief and improved shoulder function. The complication rate is considerable. Cite this article: Bone Joint J 2018;100-B:761–6.

scholarly journals Mid-term outcomes of bony increased offset-reverse total shoulder arthroplasty in the Asian population

2021 ◽  
Vol 24 (3) ◽  
pp. 125-134
Author(s):  
Kirtan Tankshali ◽  
Dong-Whan Suh ◽  
Jong-Hun Ji ◽  
Chang-Yeon Kim
Keyword(s):  
Los Angeles ◽  
Clinical Outcomes ◽  
Shoulder Arthroplasty ◽  
Intraoperative Complications ◽  
Total Shoulder Arthroplasty ◽  
Asian Population ◽  
Reverse Total Shoulder Arthroplasty ◽  
Scapular Notching ◽  
Reverse Total Shoulder

Background: To evaluate clinical and radiological outcomes of bony increased offset-reverse total shoulder arthroplasty (BIO-RSA) in the Asian population at mid-term follow-up.Methods: From June 2012 to August 2017 at a single center, 43 patients underwent BIO-RSA, and 38 patients with a minimum of 2 years of follow-up were enrolled. We evaluated the preoperative and postoperative clinical outcomes, radiological outcomes (notching and loosening), and complications of BIO-RSA at the last follow-up. In addition, we divided these patients into notching and not-notching groups and compared the demographics, preoperative, and postoperative characteristics of patients between the two groups.Results: Visual analog scale, American Shoulder and Elbow Surgeons, University of California-Los Angeles, and Simple Shoulder Test scores improved significantly from preoperative (average: 5, 39.43, 16.22, 3.94) to postoperative (average: 1.71, 78.91, 28.34, 7.8; p<0.05) outcomes. All range of motion except internal rotation improved significantly at the final follow-up (p<0.05), and the bone graft was well-incorporated with the native glenoid in all patients (100%). However, scapular notching was observed in 20/38 patients (53%). In the comparison between notching and not-notching groups (18 vs. 20 patients), there were no significant differences in demographics, radiological parameters, and clinical outcomes except acromion-greater tuberosity (AT) distance (p=0.003). Intraoperative complications were three metaphyseal fractures and one inferior screw malposition. Postoperative complications included one heterotopic ossification, one scapula neck stress fracture, one humeral stem loosening, and one late infection.Conclusions: BIO-RSA resulted in improved clinical outcomes at mid-term follow-up in the Asian population. Although better cosmesis and advantages of glenoid lateralization were observed, we observed higher rates of scapular notching compared to previously reported rates in BIO-RSA studies. In addition, adequate glenoid lateralization with appropriate humeral lengthening (AT distance) might reduce scapular notching.

scholarly journals Near-simultaneous bilateral reverse total shoulder arthroplasty for the treatment of bilateral fracture dislocations of the shoulder

2019 ◽  
Vol 12 (10) ◽  
pp. e230212 ◽  
Author(s):  
Alexander Wendling ◽  
Matthew L Vopat ◽  
Shang-You Yang ◽  
Bradley Saunders
Keyword(s):  
Shoulder Arthroplasty ◽  
Treatment Plan ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Left Shoulder ◽  
Fracture Dislocations ◽  
Bilateral Fracture ◽  
Reverse Total Shoulder

A man in his mid-80s presented with bilateral posterior fracture dislocations of the humerus after suffering a seizure. He had Parskinson’s disease and lived with his wife at home. His left shoulder was not felt to be reconstructable. The initial treatment plan was to perform reverse total shoulder arthroplasty (rTSA) on the left and non-operatively reduce his right shoulder. A left rTSA was performed, but his right shoulder was unstable due to a glenoid fracture and soft tissue instability. In order to preserve the patient’s quality of life, a right rTSA was performed 4 days later. In the follow-up period, the patient was able to regain enough pain-free range of motion on activities of daily living. The patient died from complications of Parkinson’s disease 10 months postoperatively.

scholarly journals The use of an eccentric glenosphere compared with a concentric glenosphere in reverse total shoulder arthroplasty: two-year minimum follow-up results

2013 ◽  
Vol 37 (10) ◽  
pp. 1949-1955 ◽  
Author(s):  
Carlo Felice De Biase ◽  
Giovanni Ziveri ◽  
Marco Delcogliano ◽  
Francesca de Caro ◽  
Stefano Gumina ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder

Early Follow-up of Reverse Total Shoulder Arthroplasty in Patients Sixty Years of Age or Younger

2013 ◽  
Vol 95 (20) ◽  
pp. 1877-1883 ◽  
Author(s):  
Stephanie J. Muh ◽  
Jonathan J. Streit ◽  
John Paul Wanner ◽  
Christopher J. Lenarz ◽  
Yousef Shishani ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder

scholarly journals Is reverse total shoulder arthroplasty (rTSA) more advantageous than anatomic TSA (aTSA) for osteoarthritis with intact cuff tendon? A systematic review and meta-analysis

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Hyojune Kim ◽  
Chul-Ho Kim ◽  
Minsoo Kim ◽  
Wonsun Lee ◽  
In-Ho Jeon ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
Revision Rate ◽  
Meta Analysis ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Functional Scores ◽  
Reverse Total Shoulder ◽  
Glenoid Loosening

Abstract Purpose We aimed to compare the outcomes and complications of anatomical shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) for primary glenohumeral osteoarthritis with intact cuff tissue. Materials and methods The MEDLINE, Embase, and Cochrane Library databases were systematically searched for studies published before March 2, 2021 using the PRISMA guidelines. Studies were included if they directly compared aTSA and rTSA for treating primary glenohumeral arthritis. A meta-analysis was performed using six studies that compared radiologic outcomes, functional scores, and range of motion (ROM). All the data were pooled using a random-effects model. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated as dichotomous data, while continuous data were analyzed using mean differences with 95% CIs. Results Two independent researchers reviewed 1,061 studies. Six studies met the inclusion criteria. The range of motion, especially external rotation, was better for aTSA than for rTSA (MD = − 10.28, 95% CI: − 16.69 to − 3.88, P = 0.002). Functional scores showed no difference between aTSA and rTSA. Glenoid loosening (OR = 0.17, 95% CI: 0.06–0.50, P = 0.001) was more common with aTSA, and scapula notching (OR = 10.63, 95% CI: 1.73–65.27, P = 0.01) with rTSA. In the mid-term follow-up, the overall revision rate showed no difference between aTSA and rTSA, with a pooled OR of 0.33 (95% CI: 0.07–1.57, P = 0.16). Conclusion A better ROM was achieved after aTSA than after rTSA. There was no difference in the revision rate at mid-term follow-up between aTSA and rTSA. Glenoid loosening was more common with aTSA, and scapula notching with rTSA. Level of evidence: Level IV, Meta-analysis.

scholarly journals Anatomical and reverse shoulder arthroplasty utilizing a single implant system with a platform stem: A prospective observational study with midterm follow-up

2019 ◽  
Vol 12 (5) ◽  
pp. 330-337
Author(s):  
Lindsay Flynn ◽  
Matthew R Patrick ◽  
Christopher Roche ◽  
Joseph D Zuckerman ◽  
Pierre-Henri Flurin ◽  
...  
Keyword(s):  
Los Angeles ◽  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Outcome Scores ◽  
Implant System ◽  
Reverse Total Shoulder

Background No studies compare outcomes of anatomic total shoulder arthroplasty to reverse total shoulder arthroplasty with more than five-year follow-up. Methods A multicenter prospectively collected shoulder registry was utilized to review all patients undergoing primary anatomic total shoulder arthroplasty or primary reverse total shoulder arthroplasty with a minimum five-year follow-up utilizing a single platform stem implant system. One-hundred-ninety-one patients received an anatomic total shoulder arthroplasty and 139 patients received a reverse total shoulder arthroplasty. Patients were scored preoperatively and at latest follow-up using the simple shoulder test (SST), University of California Los Angeles (UCLA), American shoulder and elbow surgeons (ASES), Constant, and shoulder pain and disability index (SADI) scores as well as range of motion. Radiographs were evaluated for implant loosening or notching. Complications were reviewed. A Student’s two-tailed, unpaired t-test identified differences in preoperative, postoperative, and pre-to-postoperative improvements. Results Reverse total shoulder arthroplasty patients were significantly older than anatomic total shoulder arthroplasty patients. All patients demonstrated significant improvement in functional metric scores and range of motion following anatomic total shoulder arthroplasty or reverse total shoulder arthroplasty. There was no difference in final outcome scores between anatomic total shoulder arthroplasty and reverse total shoulder arthroplasty patients at midterm follow-up; however, reverse total shoulder arthroplasty patients demonstrated significantly less motion. Discussion We demonstrate equivalent outcomes with five scoring metrics at mean follow-up of 71.3 ± 14.1 months. Although postoperative scores were significantly greater than preoperative scores for both anatomic total shoulder arthroplasty and reverse total shoulder arthroplasty patients, significant differences in outcome scores between cohorts were not observed.

Sign in / Sign up

Export Citation Format

Share Document