scholarly journals Impact of Sports Activity on Medium-Term Clinical and Radiological Outcome after Reverse Shoulder Arthroplasty in Cuff Deficient Arthropathy; An Institutional Register-Based Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 828
Author(s):  
David Endell ◽  
Laurent Audigé ◽  
Alexandra Grob ◽  
Hans-Kaspar Schwyzer ◽  
Michael Glanzmann ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Shoulder Arthroplasty ◽  
Constant Score ◽  
Reverse Shoulder Arthroplasty ◽  
Lower Extremities ◽  
Prosthesis Loosening ◽  
Sports Activity ◽  
Functional Scores ◽  
Clinical And Radiological Outcome ◽  
Rotator Cuff Deficiency

There is a lack of consensus on what physicians can recommend and what patients can expect concerning sports activity after reverse shoulder arthroplasty (RSA). The purpose of this retrospective register-based observational study was to investigate the association between participation in sports or physical activity involving the upper extremity and 5-year clinical and radiological outcomes for primary RSA patients. We screened the institutional arthroplasty registry for patients reporting the type and level of sports postoperatively after primary, unilateral RSA due to rotator cuff deficiency. One hundred thirty-eight patients with clinical and radiological outcomes documented at a minimum 5-year follow-up were divided into three groups comprising those who participated regularly in: sports mainly involving the upper extremity (sports upper extremities, SUE, n = 49), sports mainly involving the lower extremities (sports lower extremities, SLE, n = 21), and those who did not participate in sports at all (no sports, NS, n = 68). The participants had a mean age of 72 years (standard deviation (SD) 8) and were overall predominantly female patients (62%). Primary clinical outcomes included the Constant Score (CS) and Shoulder Pain and Disability Index (SPADI). Secondary radiographs were analyzed for radiolucent lines (RLL), signs of glenoid or humeral prosthesis loosening, bone resorption, bone formation, and scapular notching. A total number of 8 senior surgeons were involved in treatment of patients, and two types of prosthesis were used. The SUE group had non-significantly higher mean scores for CS (75 points) and SPADI (88 points) compared to SLE (71 and 78 points, respectively) and NS patients (66 and 78 points, respectively) (p ≥ 0.286). The incidence of RLL around the humeral diaphysis was higher in NS compared to SUE patients (32% versus 12%, respectively) (p = 0.025); all other radiological parameters were similar between the groups. There were no cases of loosening in the SUE group that led to revision surgery. Patients engaging in sports activities involving the upper extremity show similarly good functional scores 5 years post-RSA as the other groups, without additional signs of implant loosening as a result of increased shoulder use.

scholarly journals Subsidence of Uncemented Short Stems in Reverse Shoulder Arthroplasty—A Multicenter Study

2020 ◽  
Vol 9 (10) ◽  
pp. 3362
Author(s):  
Anna-K. Tross ◽  
Alexandre Lädermann ◽  
Thomas Wittmann ◽  
Marc Schnetzke ◽  
Philip-C. Nolte ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Constant Score ◽  
Reverse Shoulder Arthroplasty ◽  
Radiographic Finding ◽  
Level Of Evidence ◽  
Humeral Component ◽  
Clinical And Radiological Outcome ◽  
Potential Risk Factors ◽  
Component Loosening ◽  
Short Stems

Background: The radiological phenomenon of subsidence following the implantation of uncemented short-stem reverse prostheses (USSP) has not yet been described. The purpose of this study was to describe the rate and potential risk factors for subsidence. We hypothesized that subsidence may be a frequent finding and that a subsidence of >5 mm (mm) is associated with an inferior clinical outcome. Methods: A total of 139 patients with an average age of 73 ± 9 years were included. The clinical and radiological outcome was evaluated at a minimum follow-up (FU) of 12 months. Results: No humeral component loosening was present at a mean FU of 18 (range, 12–51) months. Mean Constant Score (CS) and Subjective Shoulder Value (SSV) improved significantly from 34.3 ± 18.0 points and 37.0 ± 19.5% preoperatively to 72.2 ± 13.4 points and 80.3 ± 16.5% at final FU (p < 0.001). The average subsidence of the USSP was 1.4 ± 3.7 mm. Subsidence of >5 mm was present in 15 patients (11%). No association between a subsidence >5 mm and CS or SSV was found (p = 0.456, p = 0.527). However, a subsidence of >5 mm resulted in lower strength at final FU (p = 0.022). Complications occurred in six cases (4.2%), and the revision rate was 3.5% (five cases). Conclusions: Although subsidence of USSP is a frequent radiographic finding it is not associated with loosening of the component or a decrease in the clinical outcome at short term FU. Level of evidence: Level 4, retrospective study.

scholarly journals Glenoid loosening and migration in reverse shoulder arthroplasty

2019 ◽  
Vol 101-B (4) ◽  
pp. 461-469 ◽  
Author(s):  
A. Lädermann ◽  
A. J. Schwitzguebel ◽  
T. B. Edwards ◽  
A. Godeneche ◽  
L. Favard ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Shoulder Arthroplasty ◽  
External Rotation ◽  
Constant Score ◽  
Reverse Shoulder Arthroplasty ◽  
Multivariable Analysis ◽  
Range Of Movement ◽  
Original Cohort ◽  
Glenoid Loosening

Aims The aim of this study was to report the outcomes of different treatment options for glenoid loosening following reverse shoulder arthroplasty (RSA) at a minimum follow-up of two years. Patients and Methods We retrospectively studied the records of 79 patients (19 men, 60 women; 84 shoulders) aged 70.4 years (21 to 87) treated for aseptic loosening of the glenosphere following RSA. Clinical evaluation included pre- and post-treatment active anterior elevation (AAE), external rotation, and Constant score. Results From the original cohort, 29 shoulders (35%) were treated conservatively, 27 shoulders (32%) were revised by revision of the glenosphere, and 28 shoulders (33%) were converted to hemiarthroplasty. At last follow-up, conservative treatment and glenoid revision significantly improved AAE, total Constant score, and pain, while hemiarthroplasty did not improve range of movement or clinical scores. Multivariable analysis confirmed that conservative treatment and glenoid revision achieved similar improvements in pain (glenoid revision vs conservative, beta 0.44; p = 0.834) but that outcomes were significantly worse following hemiarthroplasty (beta -5.00; p = 0.029). Conclusion When possible, glenoid loosening after RSA should first be treated conservatively, then by glenosphere revision if necessary, and last by salvage hemiarthroplasty Cite this article: Bone Joint J 2019;101-B:461–469.

Reverse Shoulder Arthroplasty for the Treatment of Rotator Cuff Deficiency

2017 ◽  
Vol 99 (22) ◽  
pp. 1895-1899 ◽  
Author(s):  
Derek J. Cuff ◽  
Derek R. Pupello ◽  
Brandon G. Santoni ◽  
Rachel E. Clark ◽  
Mark A. Frankle
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Rotator Cuff Deficiency

Reverse Shoulder Arthroplasty for the Treatment of Rotator Cuff Deficiency

2012 ◽  
Vol 94 (21) ◽  
pp. 1996-2000 ◽  
Author(s):  
Derek Cuff ◽  
Rachel Clark ◽  
Derek Pupello ◽  
Mark Frankle
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Rotator Cuff Deficiency

scholarly journals Bipolar lateralization in reverse shoulder arthroplasty for avoidance of scapular notching

2020 ◽  
Vol 15 (3) ◽  
pp. 207-212
Author(s):  
Patric Raiss ◽  
Rainer Neumann
Keyword(s):  
Shoulder Arthroplasty ◽  
External Rotation ◽  
Constant Score ◽  
Reverse Shoulder Arthroplasty ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Scapular Notching ◽  
Neck Shaft Angle ◽  
Shoulder Flexion

Abstract Introduction Reverse shoulder arthroplasty (RSA) has become a well-established treatment option for multiple disorders of the shoulder joint. In recent years, implant designs and configurations have been modified in order to improve function and avoid complications. Lateralization on the glenoid and the humeral side has been described to improve function and decrease radiographic scapular notching. Data on the clinical and radiographic results of bipolar lateralization in RSA are lacking. Methods In 38 cases, RSA was performed using an uncemented humeral short-stem component with a 145° neck–shaft angle in combination with bone lateralization on the glenoid side (Bony Increased-Offset Reversed Shoulder Arthroplasty, BIO-RSA; Wright Medical Inc., Memphis, TN, USA). Mean follow-up was 19 months (range 12–34 months). Patients were followed clinically using the Constant score as well as range of motion for shoulder flexion and external rotation. Radiographs in two different plains were analyzed for implant seating and the occurrence of scapular notching. Results There was a significant increase in all measured clinical parameters. Forward flexion increased from a mean of 75° preoperatively to 151° postoperatively, and mean Constant score increased from 21 to 71 points postoperatively (p < 0.001). Glenoid notching of grade 1 according to Sirveuax was observed in 3 out of 35 cases (9%); no grade 2, 3, or 4 notching was present. Revision surgery was necessary in one case (3%). Conclusion RSA with bipolar lateralization leads to excellent clinical outcomes, low complication rates, and low rates of radiographic scapular notching. Longer follow-up and prospective randomized trials are needed. Level of evidence Level IV.

scholarly journals Risk factors for instability after reverse shoulder arthroplasty

2019 ◽  
pp. 175857321986426 ◽  
Author(s):  
Vincenzo Guarrella ◽  
Mikael Chelli ◽  
Peter Domos ◽  
Francesco Ascione ◽  
Pascal Boileau ◽  
...  
Keyword(s):  
Risk Factors ◽  
Shoulder Arthroplasty ◽  
Constant Score ◽  
Reverse Shoulder Arthroplasty ◽  
Functional Results ◽  
Younger Patients ◽  
Long Term Follow Up ◽  
Shoulder Arthroplasties ◽  
Postoperative Instability

Background This study aims to identify risk factors related to postoperative instability after reverse shoulder arthroplasty and evaluate the modalities and results of treatments in a large series of patients, with medium to long-term follow-up. Methods Retrospective multicenter series of 1035 consecutive Grammont type reverse shoulder arthroplasties implanted between 1992 and 2010. 19.9% had a reverse shoulder arthroplasty with bony lateralization on the glenoid side. Patients were reviewed and radiographed with minimum five years’ follow-up. Results At a mean follow-up of eight years, the overall rate of postoperative instability was 3.0%. Instability was more frequent in case of reverse shoulder arthroplasty for revision surgery, in younger patients, in case of scapular notching, and tuberosity resorption. Lateralized reverse shoulder arthroplasties were associated with a lower instability rate. A reoperation to restore stability was needed in 70% of cases. The improvement in Constant Score was lower in patients with unstable reverse shoulder arthroplasties when compared to stable reverse shoulder arthroplasties. Conclusions Younger patients are at higher risk for instability after Grammont type reverse shoulder arthroplasty implantation. Conversely, lateralized reverse shoulder arthroplasties resulted protective. When conservative treatment had failed, shoulder stability can be obtained with reoperation or prosthetic revision (needed in 70% of the cases), but to the price of lower functional results.

Reverse Shoulder Arthroplasty in Patients With Amputation or Paralysis of the Contralateral Upper Extremity (One-Arm Patients)

PM&R ◽  
2017 ◽  
Vol 9 (10) ◽  
pp. 1006-1012
Author(s):  
Eduard Alentorn-Geli ◽  
Nathan R. Wanderman ◽  
Andrew T. Assenmacher ◽  
Bassem T. Elhassan ◽  
Joaquín Sánchez-Sotelo ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty
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