scholarly journals Return to Sport after Anatomic and Reverse Total Shoulder Arthroplasty in Elderly Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (5) ◽  
pp. 1576
Author(s):  
Rocco Papalia ◽  
Mauro Ciuffreda ◽  
Erika Albo ◽  
Chiara De Andreis ◽  
Lorenzo Alirio Diaz Balzani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Elderly Patients ◽  
Shoulder Arthroplasty ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Total Shoulder Arthroplasty ◽  
Case Series ◽  
Return To Sport ◽  
Rate Of Return ◽  
Cochrane Library

The aim of this systematic review and meta-analysis was to evaluate the rate of return to sport in elderly patients who underwent anatomic (ATSA) and reverse (RTSA) total shoulder arthroplasty, to assess postoperative pain and functional outcomes and to give an overview of postoperative rehabilitation protocols. A systematic search in Pubmed-Medline, Cochrane Library, and Google Scholar was carried out to identify eligible randomized clinical trials, observational studies, or case series that evaluated the rate of return to sport after RTSA or ATSA. Six retrospective studies, five case series, and one prospective cohort study were included in this review. The overall rate of return to sport was 82% (95% CI 0.76–0.88, p < 0.01). Patients undergoing ATSA returned at a higher rate (90%) (95% CI 0.80–0.99, p < 0.01) compared to RTSA (77%) (95% CI 0.69–0.85, p < 0.01). Moreover, the results showed that patients returned to sport at the same or a higher level in 75% of cases. Swimming had the highest rate of return (84%), followed by fitness (77%), golf (77%), and tennis (69%). Thus, RTSA and ATSA are effective to guarantee a significative rate of return to sport in elderly patients. A slightly higher rate was found for the anatomic implant.

Return to sport after reverse total shoulder arthroplasty is highly frequent: a systematic review

2021 ◽  
pp. jisakos-2020-000581
Author(s):  
Edoardo Franceschetti ◽  
Edoardo Giovannetti de Sanctis ◽  
Pietro Gregori ◽  
Alessio Palumbo ◽  
Michele Paciotti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Return To Sport ◽  
Rate Of Return ◽  
Return To Sports ◽  
The Mean ◽  
Reverse Total Shoulder ◽  
Subjective Level

ImportanceOne of the most frequent concerns of the increasing number of patients undergoing shoulder arthroplasty is the possibility to resume sport after surgery.ObjectiveThe aim of this systematic review was to determine the rate of return to sport after reverse total shoulder arthroplasty (RSA) and the subjective level of performance.Evidence reviewThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to perform this systematic review. A systematic electronic search was performed using the PubMed (MEDLINE), Embase and Cochrane Library databases. All the studies analysing the rates were pooled; data were extracted and statistically analysed. The eligibility criteria were studies with at least 20 adult patients recruited. All studies had to relate return to sports after RSA.FindingsA total of six studies were included for a total of 457 patients. Mean age and average follow-up were, respectively, 74.7 years (range 33–88 years) and 3.6 years (range 1–9.4 years). The mean rate of return to sport ranged from 60% to 93%. The mean time for resuming sports was 5.3 months. The overall rate of return to sport after reverse shoulder arthroplasty was 79%. The mean level of sports at the time of the survey was worsened in 7.9%, improved in 39.6% and had no change in 55.2% of the cases.Conclusions and relevanceBased on the current available data, return to sports after reverse shoulder arthroplasty is possible and highly frequent. The subjective level of practice undergoes no change or improves in most of the cases. More studies and better-designed trials are needed in order to enrich the evidence on specific sports recovery after the procedure.Level of evidenceIV.

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.

Return to Sport After Shoulder Arthroplasty in Recreational Athletes: A Systematic Review and Meta-analysis

2017 ◽  
Vol 46 (5) ◽  
pp. 1251-1257 ◽  
Author(s):  
Florence Aim ◽  
Jean-David Werthel ◽  
Julien Deranlot ◽  
Marie Vigan ◽  
Geoffroy Nourissat
Keyword(s):  
Systematic Review ◽  
Shoulder Arthroplasty ◽  
Meta Analysis ◽  
Reverse Shoulder Arthroplasty ◽  
Return To Sport ◽  
Rate Of Return ◽  
Shoulder Replacement ◽  
Recreational Athletes ◽  
Replacement Surgery ◽  
Radiological Data

Background: One of the most frequent demands from patients after shoulder replacement surgery is to return to sport. Purpose: To determine the rate of return to sport after shoulder arthroplasty (total shoulder arthroplasty, reverse shoulder arthroplasty, hemiarthroplasty) in recreational athletes. Study Design: Meta-analysis and systematic review. Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to perform this systematic review and meta-analysis of the results in the literature as well as the presentation of results. A search of the literature was performed in the electronic databases MEDLINE, Scopus, Embase, and the Cochrane Library. The quality of the included studies was evaluated according to the MINORS (Methodological Index for Nonrandomized Studies) score. Inclusion criteria were studies in English evaluating return to sport after shoulder replacement surgery and on patients practicing a sport regularly, whatever the level, with all ages and sports included. The main criterion was the rate of patients who returned to a sport activity. Results: Nine studies were selected among the 35 identified, including a total of 613 patients (39% male and 61% female) with a mean age of 71.7 years (range, 22.6-92.6 years). All the included patients practiced sports before surgery. The most common reported sports were golf (n = 140), swimming (n = 128), and tennis (n = 54). The mean rate of return to sport was 80.7% (range, 57.1%-97.3%). All patients who returned to sport were practicing in the 3 months before surgery. No radiological data were reported in the literature. The subgroup analysis for resuming golf after shoulder arthroplasty revealed a rate of return to sport of 79.2% (95% CI, 62.9%-89.5%). In the swimming subgroup, the rate was 75.6% (95% CI, 61.3%-85.8%) and in the tennis subgroup was 63.5% (95% CI, 34.1%-85.5%). The subgroup analysis for reverse shoulder arthroplasty reported a lower rate of return to sport than for all types of shoulder arthroplasty combined: 76.5% (95% CI, 60%-87%) versus 80.7% (95% CI, 70.9%-87.8%), respectively. Conclusion: Most patients returned to sport after surgery, and all who returned to sport were practicing their sport in the 3 months before surgery. No radiological data were reported in the literature.

Platelet Concentrate Treatments for Temporomandibular Disorders: A Systematic Review and Meta-analysis

2020 ◽  
pp. 238008442092732
Author(s):  
F.S. Al-Hamed ◽  
A. Hijazi ◽  
Q. Gao ◽  
Z. Badran ◽  
F. Tamimi
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Mouth Opening ◽  
Case Series ◽  
Platelet Concentrate ◽  
Current Evidence ◽  
Disc Displacement ◽  
Temporomandibular Joint Osteoarthritis ◽  
Vas Scores

Objectives: This systematic review compared platelet concentrates (PCs) versus hyaluronic acid (HA) or saline/Ringer’s solution injections as treatments of temporomandibular osteoarthritis and disc displacement in terms of pain and maximum mouth opening (MMO). Methods: PubMed, Cochrane, and Scopus were searched up to March 6, 2020. Inclusion criteria were randomized clinical trials (RCTs). Exclusion criteria were case series, observational studies, animal studies, and reviews. The Effective Public Health Practice Project (EPHPP) quality assessment tool was used to assess the risk of bias in the included studies. The weighted mean difference was used to compare the results. Results: Nine RCTs were included with a total of 407 patients. The numbers of joints treated were 262, 112, and 112 in the PC, HA, and saline groups, respectively. The quality of studies was rated as strong in 4 studies, moderate in 4 studies, and weak in 1 study. The meta-analysis revealed that PCs decreased pain visual analogue scale (VAS) scores compared to HA by an average of −1.11 (CI, −1.62 to −0.60; P < 0.0001) and −0.57 (CI, −1.55 to 0.41; P = 0.26) at 3 and 12 mo follow-up respectively. Also, the average decrease in pain scores with PC compared to saline was −1.33 (CI, −2.61 to −0.06; P = 0.04), −2.07 (CI, −3.46 to −0.69; P = 0.003), and −2.71 (CI, −4.69 to −0.72; P = 0.008) at 3, 6, and 12 mo, respectively. Regarding MMO measurements, PC was comparable to HA, but it was significantly better than saline after 3 and 6 mo [2.9 mm (CI,1.47 to 4.3; P < 0.0001), and 1.69 mm (CI, 0.13 to 3.25; P = 0.03) respectively]. Conclusion: PC reduces pain VAS scores compared to HA during the first 3 m after treatment, and when compared to saline, it reduces pain and increases MMO for longer durations. However, due to differences between groups regarding PC preparation protocols and study heterogeneity, further standardized RCTs are required. Knowledge Transfer Statement: This study provides researchers and clinicians with quantitative and qualitative analyses of the current evidence regarding the clinical outcomes of platelet concentrate injections in the treatment of temporomandibular joint osteoarthritis and disc displacement in terms of pain control and maximum mouth opening.

Stemless anatomic total shoulder arthroplasty: a systematic review and meta-analysis

2020 ◽  
Vol 29 (9) ◽  
pp. 1928-1937
Author(s):  
Eva Y. Liu ◽  
Dorsa Kord ◽  
Nolan S. Horner ◽  
Timothy Leroux ◽  
Bashar Alolabi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Arthroplasty ◽  
Meta Analysis ◽  
Total Shoulder Arthroplasty

scholarly journals Effectiveness of formal physical therapy following total shoulder arthroplasty: A systematic review

2018 ◽  
Vol 12 (2) ◽  
pp. 136-143 ◽  
Author(s):  
Peter K Edwards ◽  
Jay R Ebert ◽  
Chris Littlewood ◽  
Tim Ackland ◽  
Allan Wang
Keyword(s):  
Systematic Review ◽  
Physical Therapy ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Cochrane Library ◽  
Future Research ◽  
Routine Practice ◽  
Post Surgery ◽  
Reverse Total Shoulder

Background Physical therapy is considered routine practice following total shoulder arthroplasty. To date, current regimens are based on clinical opinion, with evidence-based recommendations. The aim of this systematic review was to evaluate the effectiveness of total shoulder arthroplasty physical therapy programmes with a view to inform current clinical practice, as well as to develop a platform upon which future research might be conducted. Methods An electronic search of MEDLINE, EMBASE, CINAHL and Cochrane Library to March 2018 was complemented by hand and citation-searching. Studies were selected in relation to pre-defined criteria. A narrative synthesis was undertaken. Results A total of 506 papers were identified in the electronic database search, with only one study showing moderate evidence of early physical therapy promoting a more rapid return of short-term improvement in function and pain. No studies evaluated the effectiveness of physical therapy programmes in reverse total shoulder arthroplasty procedures. Discussion Restoring range of motion and strength following total shoulder arthroplasty is considered important for patients to obtain a good outcome post-surgery and, when applied early, may offer more rapid recovery. Given the rising incidence of total shoulder arthroplasties, especially reverse total shoulder arthroplasty, there is an urgent need for high-quality, adequately powered randomised controlled trials to determine the effectiveness of rehabilitation programmes following these surgeries.

scholarly journals Acromial fracture after reverse total shoulder arthroplasty: a systematic review

2019 ◽  
Vol 12 (6) ◽  
pp. 375-389 ◽  
Author(s):  
Simon C Lau ◽  
Richard Large
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Stress Fracture ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Revision Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Cochrane Library ◽  
Acromial Fracture ◽  
Reverse Total Shoulder

Background The reverse total shoulder arthroplasty has become the most common method of arthroplasty of the shoulder. The complication of acromial or scapular stress fracture deserves consideration to describe incidence and determine whether prosthetic design or patient factors act as risk factors. Methods A systematic review of the literature was performed including the EMBASE, Medline and the Cochrane Library in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results The search returned 565 articles. After exclusion, 25 papers remained. In total, 208 fractures were reported in the literature, with an overall incidence of 5% and stress fractures were more common than post-traumatic ones; 24 fractures underwent osteosynthesis and there were nine revision arthroplasty surgeries. Outcomes worsened after fracture – whether treated with surgery or not. In patients with scapular base fractures, there was an improvement in functional outcome scores after surgery. Heterogeneous reporting of the risk factors prior to fractures, treatment methods and outcomes made recommendations weak. Discussion Acromial stress fracture after reverse total shoulder arthroplasty occurs relatively commonly but is poorly reported in the literature. It is unclear whether immobilisation, fixation or revision arthroplasty is the best treatment, although fixation may offer a better outcome. In future, reports should aim for greater consistency to allow a better understanding of this condition.

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