Polyethylene Liner Dissociation after Reverse Shoulder Arthroplasty Dislocation: a Case Series

Background Reverse shoulder arthroplasty (RSA) has revolutionized the management of many shoulder pathologies. Lateralization has become favourable to combat complications (e.g. notching, compromised external rotation), using a metallic, or autogenous bone-graft baseplates – bony increased-offset reverse shoulder arthroplasty (BIO-RSA). We systematically reviewed the literature to determine: Does BIO-RSA improve range of motion and outcome scores? Are notching rates decreased? Does the graft heal? Methods All available prospective studies, trials and case series reporting on BIO-RSA were included. Outcomes were grouped into outcome scores, range of motion and radiographic outcomes. Data were pooled and statistical analysis performed. Results Eight studies reported on 385 RSA – 235 BIO-RSA and 150 standard-RSA (STD-RSA). Follow-up was 20–36 months; average age 74 years. Outcome scores: Constant-Murley and SSV scores showed statistically significant post-operative benefit of BIO-RSA (mean-difference 4.0 (95% confidence interval (CI): 0.79,7.1) and 6.8 (95% CI: 3.8, 9.9)). No Minimal Clinically Importance Difference was surpassed. Range of motion: No difference was found in any direction. Notching: Notching was less likely with BIO-RSA (odds ratio 0.19 (95% CI: 0.10, 0.38)). Healing and loosening: 92% grafts fully healed/incorporated. Loosening rate was 2.4%. Conclusions Literature on BIO-RSA is limited with only one randomised controlled trial (RCT). Weak evidence exists for improved outcome scores. Range of motion is equivocal. Notching rates are significantly lower in BIO-RSA. The graft usually heals.

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Reverse shoulder arthroplasty after failed pectoralis major tendon transfer with a minimum follow-up of 5 years. A case series

Journal of Orthopaedic Science ◽

10.1016/j.jos.2016.05.001 ◽

2016 ◽

Vol 21 (5) ◽

pp. 591-595 ◽

Cited By ~ 5

Author(s):

Reinhold Ortmaier ◽

Fabian Plachel ◽

Stefan Lederer ◽

Wolfgang Hitzl ◽

Alexander Auffarth ◽

...

Keyword(s):

Shoulder Arthroplasty ◽

Tendon Transfer ◽

Reverse Shoulder Arthroplasty ◽

Case Series ◽

Pectoralis Major

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Reverse shoulder arthroplasty for proximal humerus fracture using a dedicated stem: radiological outcomes at a minimum 2 years of follow-up—case series

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-015-0261-1 ◽

2015 ◽

Vol 10 (1) ◽

Cited By ~ 32

Author(s):

Raffaele Garofalo ◽

Brody Flanagin ◽

Alessandro Castagna ◽

Eddie Y Lo ◽

Sumant G Krishnan

Keyword(s):

Shoulder Arthroplasty ◽

Proximal Humerus Fracture ◽

Proximal Humerus ◽

Reverse Shoulder Arthroplasty ◽

Case Series ◽

Humerus Fracture

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Reverse Shoulder Arthroplasty for Failed Proximal Humerus Osteosynthesis With Intramedullary Allograft: A Case Series

Journal of Shoulder and Elbow Arthroplasty ◽

10.1177/2471549220925464 ◽

2020 ◽

Vol 4 ◽

pp. 247154922092546

Author(s):

Teja Polisetty ◽

Paul DeVito ◽

Hyrum Judd ◽

Andrew Malarkey ◽

Jonathan C Levy

Keyword(s):

Pain Relief ◽

Shoulder Arthroplasty ◽

Proximal Humerus ◽

Intraoperative Complications ◽

Reverse Shoulder Arthroplasty ◽

Case Series ◽

Proximal Humerus Fractures ◽

Surgical Time ◽

Surgeon Experience ◽

Humerus Fractures

Introduction The presence of retained intramedullary fibular allograft presents many challenges during reverse shoulder arthroplasty (RSA), which have been discussed in limited fashion. This case series presents a single-surgeon experience with 6 patients treated with RSA following failed osteosynthesis of proximal humerus fractures using intramedullary allografts. Methods A retrospective review was conducted of RSA patients with a minimum of 2-year follow-up (exception of 1 deceased patient) for failed plate fixation of proximal humerus fractures. Two cohorts were created based on the presence of an intramedullary allograft during the procedure. Patient-reported outcome measures, active range of motion, time to revision, surgical time, complications, and case descriptions were obtained from chart review and radiographic analysis. Results When treating patients with a retained allograft, the surgeon used a guide pin from a cannulated screw set to advance through the graft, and a cannulated drill was used to ream and bypass the allograft, contributing to a 22% increase in surgical time (151 vs 124 min). Intraoperative complications were observed only in the allograft cohort (50%; 3 of 6), including cortical perforation with cement extrusion, humeral loosening, and proximal humerus bone loss. Patients treated with a retained allograft experienced pain relief ( P = .001) but did not gain significant functional improvements. Conclusion RSA for failed proximal humerus fixation with healed intramedullary allograft is associated with increased operative time and intraoperative complications, and patients can mostly expect pain relief. Techniques for humeral canal preparation and stem placement to bypass the allograft are helpful in managing these revisions.

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Does ORIF of rare scapular spine fractures sustained after reverse shoulder arthroplasty benefit elderly patients? A case-series appraisal

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2019.07.023 ◽

2019 ◽

Vol 105 (8) ◽

pp. 1521-1528

Author(s):

Felix Toft ◽

Fabrizio Moro

Keyword(s):

Elderly Patients ◽

Shoulder Arthroplasty ◽

Reverse Shoulder Arthroplasty ◽

Case Series ◽

Spine Fractures ◽

Scapular Spine

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The effect of glenoid component version and humeral polyethylene liner rotation on subluxation and impingement in reverse shoulder arthroplasty

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2017.03.027 ◽

2017 ◽

Vol 26 (10) ◽

pp. 1718-1725 ◽

Cited By ~ 6

Author(s):

Vijay N. Permeswaran ◽

Andrea Caceres ◽

Jessica E. Goetz ◽

Donald D. Anderson ◽

Carolyn M. Hettrich

Keyword(s):

Shoulder Arthroplasty ◽

Reverse Shoulder Arthroplasty ◽

Polyethylene Liner ◽

Glenoid Component

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Reverse shoulder arthroplasty with os acromiale

Clinics in Shoulder and Elbow ◽

10.5397/cise.2019.00409 ◽

2020 ◽

Vol 23 (2) ◽

pp. 100-104

Author(s):

Woo-Jin Shin ◽

Hyun-Ju Lee ◽

Ki-Yong An

Keyword(s):

Shoulder Arthroplasty ◽

Reverse Shoulder Arthroplasty ◽

Case Series ◽

Asian Population ◽

Deltoid Muscle ◽

Limited Range ◽

Cuff Tear ◽

Os Acromiale ◽

Limited Range Of Motion ◽

Before And After

Function and strength of the deltoid muscle are important in reverse shoulder arthroplasty (RSA). Moreover, location and shape of the acromion, clavicle, and scapular spine, which are origins of the deltoid muscle, are also important. The frequency of os acromiale is 5% to 15%; however, it is rare in the Asian population, affecting approximately 0.7% of Koreans. RSA has rarely been reported in patients with os acromiale. We present a case series of two patients with cuff tear and arthropathy combined with os acromiale who underwent RSA. From 2016 to 2018, two patients with os acromiale who presented with pain and limited range of motion (ROM) underwent RSA with cuff tear arthropathy using the subscapularis-sparing deltopectoral approach. Their ROM, visual analog scale (VAS), and satisfaction were evaluated before and after surgery. In both patients, VAS decreased, ROM increased, and postoperative satisfaction increased. There were no specific complications due to os acromiale. The VAS, ROM, and satisfaction of patients improved after surgery compared with values before surgery. Thus, os acromiale is not a contraindication for RSA. However, careful attention must be given during surgery to ensure optimal repair and recovery.

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Return to Sports After Primary Reverse Shoulder Arthroplasty: Outcomes at Mean 4-Year Follow-up

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211012393 ◽

2021 ◽

Vol 9 (6) ◽

pp. 232596712110123

Author(s):

Jennifer Tangtiphaiboontana ◽

Kristin C. Mara ◽

Andrew R. Jensen ◽

Christopher L. Camp ◽

Mark E. Morrey ◽

...

Keyword(s):

Shoulder Arthroplasty ◽

Sport Participation ◽

Reverse Shoulder Arthroplasty ◽

Case Series ◽

Rate Of Return ◽

Return To Sports ◽

Limited Information ◽

High Demand ◽

The Mean

Background: With the expanding use of reverse shoulder arthroplasty (RSA) to treat various shoulder conditions, there has been a rise in the number of RSAs performed, especially in physically active patients. Limited information regarding sports after RSA is available to properly counsel patients on postoperative expectations. Purpose: To assess the rate of return to sports as well as the ability to return to the same level of preoperative intensity, frequency, and duration of sport after primary RSA. Study Design: Case series; Level of evidence, 4. Methods: This was a retrospective review of patients who underwent primary RSA at our institution between 2014 and 2016. Shoulder motion, Subjective Shoulder Value score, American Shoulder and Elbow Surgeons score, pre- and postoperative sports activities, and barriers to return to sport were assessed in 109 patients after RSA (93 patients with unilateral RSA and 16 patients with bilateral RSA). The mean age at the time of surgery was 70 years (range, 34-86 years), with a mean follow-up of 3.9 years (range, 2-12 years). Results: The mean rate of return to sports was 70.1% (range, 0%-100%). There was no difference in return to sports between those with uni- and bilateral RSA ( P = .64). Fishing, swimming, elliptical/treadmill, and hunting were the most common sports after RSA with return rates of 91%, 73%, 86%, and 82% respectively. A majority of patients returned to the same level of preoperative intensity, frequency, and duration for all sports except for climbing and swimming. There was a lower mean rate of return for high-demand sports (62.9%) compared with low- and medium-demand sports (76.7%) ( P = .005). The most common reasons for inability to return to sports included limited motion, fear of injury, and weakness. Conclusion: Patients who had undergone primary uni- or bilateral RSA reported a 70.1% rate of return to sports with maintenance of the same level of intensity, duration, and frequency of preoperative sport participation. Rates of return to high-demand sports were lower than low- and medium-demand sports. Patients also had difficulty returning to overhead sports.

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