scholarly journals Patient-specific Guides Using 3-dimensional Reconstruction Provide Accuracy and Reproducibility in Reverse Total Shoulder Arthroplasty

2019 ◽  
Vol 22 (1) ◽  
pp. 16-23
Author(s):  
Jong Pil Yoon ◽  
Dong Hyun Kim ◽  
Jae Wook Jung ◽  
Chang-Hwa Lee ◽  
Seunggi Min ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Conventional Group ◽  
Patient Specific ◽  
Glenoid Component ◽  
3 Dimensional ◽  
Humeral Component ◽  
Dimensional Reconstruction ◽  
Reverse Total Shoulder

Background: We aimed to evaluate whether the use of our novel patient-specific guide (PSG) with 3-dimensional reconstruction in reverse total shoulder arthroplasty (RTSA) would allow accurate and reliable implantation of the glenoid and humeral components.Methods: 20 fresh-frozen cadaveric shoulders were used. The PSG group (n=10) and conventional group (n=10) was evaluated the accuracy and reproducibility of implant positioning between before and after surgery on the computed tomography image.Results: The superoinferior and anteroposterior offset in the glenoid component were 0.42 ± 0.07, 0.50 ± 0.08 in the conventional group and 0.45 ± 0.03, 0.46 ± 0.02 in the PSG group. The inclination and version angles were -1.93° ± 4.31°, 2.27° ± 5.91° and 0.46° ± 0.02°, 3.38° ± 2.79°. The standard deviation showed a smaller difference in the PSG group. The anteroposterior and lateromedial humeral canal center offset in the humeral component were 0.45 ± 0.12, 0.48 ± 0.15 in the conventional group and 0.46 ± 0.59 (<i>p</i>=0.794), 0.46 ± 0.06 (<i>p</i>=0.702) in the PSG group. The PSG showed significantly better humeral stem alignment.Conclusions: The use of PSGs with 3-dimensional reconstruction reduces variabilities in glenoid and humerus component positions and prevents extreme positioning errors in RTSA.

Complication and revision rates after reverse total shoulder revision from hemiarthroplasty: a systematic review

2021 ◽  
pp. 175857322110193
Author(s):  
Arjun K Reddy ◽  
Jake X Checketts ◽  
B Joshua Stephens ◽  
J Michael Anderson ◽  
Craig M Cooper ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Arthroplasty ◽  
Revisional Surgery ◽  
Total Shoulder Arthroplasty ◽  
Surgical Site Infections ◽  
Total Sample ◽  
Reverse Total Shoulder Arthroplasty ◽  
Common Complication ◽  
Humeral Component ◽  
Reverse Total Shoulder

Background Thus, the purpose of the present study was to (1) characterize common postoperative complications and (2) quantify the rates of revision in patients undergoing hemiarthroplasty to reverse total shoulder arthroplasty revisional surgery. We hypothesize that hardware loosenings will be the most common complication to occur in the sample, with the humeral component being the most common loosening. Methods This systematic review adhered to PRISMA reporting guideline. For our inclusion criteria, we included any study that contained intraoperative and/or postoperative complication data, and revision rates on patients who had undergone revision reverse total shoulder arthroplasty due to a failed hemiarthroplasty. Complications include neurologic injury, deep surgical site infections, hardware loosening/prosthetic instability, and postoperative fractures (acromion, glenoid, and humeral fractures). Results The study contained 22 studies that assessed complications from shoulders that had revision reverse total shoulder arthroplasty from a hemiarthroplasty, with a total sample of 925 shoulders. We found that the most common complication to occur was hardware loosenings (5.3%), and of the hardware loosenings, humeral loosenings (3.8%) were the most common. The revision rate was found to be 10.7%. Conclusion This systematic review found that revision reverse total shoulder arthroplasty for failed hemiarthroplasty has a high overall complication and reintervention rates, specifically for hardware loosening and revision rates.

Humeral component retroversion in reverse total shoulder arthroplasty: a biomechanical study

2012 ◽  
Vol 21 (9) ◽  
pp. 1121-1127 ◽  
Author(s):  
Lawrence V. Gulotta ◽  
Dan Choi ◽  
Patrick Marinello ◽  
Zakary Knutson ◽  
Joseph Lipman ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Biomechanical Study ◽  
Reverse Total Shoulder Arthroplasty ◽  
Humeral Component ◽  
Reverse Total Shoulder

Preoperative three-dimensional computer planning for reverse total shoulder arthroplasty and bone grafting for severe glenoid deformity

2020 ◽  
pp. 175857322090890
Author(s):  
Robert Z Tashjian ◽  
Lindsay Beck ◽  
Irene Stertz ◽  
Peter N Chalmers
Keyword(s):  
Shoulder Arthroplasty ◽  
Bone Grafting ◽  
Total Shoulder Arthroplasty ◽  
Three Dimensional ◽  
Reverse Total Shoulder Arthroplasty ◽  
Patient Specific ◽  
Computer Assisted ◽  
Patient Specific Instrumentation ◽  
Reverse Total Shoulder ◽  
Glenoid Erosion

Background Computer assisted planning without patient specific instrumentation may be utilized to guide reverse total shoulder arthroplasty baseplate placement. The purpose of this study was to determine the difference between planned and achieved inclination and retroversion correction with three-dimensional preoperative computer assisted planning in reverse total shoulder arthroplasty without patient specific instrumentation with bone grafting for severe glenoid erosion. Methods Preoperative three-dimensional computer assisted planning without patient specific instrumentation was performed on 15 patients undergoing primary reverse total shoulder arthroplasty with glenoid bone grafting for severe glenoid erosion. On preoperative and immediate postoperative computed tomography slices, two-dimensional retroversion and inclination were measured. Preoperative three-dimensional baseline retroversion and inclination and planned postoperative three-dimensional retroversion and inclination were measured. Planned and achieved version and inclination changes were compared. Results The planned and achieved retroversion corrections were 18° and 12°, respectively (p < 0.001). The planned and achieved inclination corrections were 11° and 11°, respectively (p = 0.803). Conclusions Three-dimensional computer assisted planning without patient specific instrumentation in the setting of reverse total shoulder arthroplasty with severe glenoid erosion requiring bone grafting can accurately guide baseplate placement. All cases in which failure to correct retroversion or inclination within 10° of planning occurred in patients with severe erosion (B3 or E3 glenoids), therefore patient specific guides may be warranted in these cases to improve accuracy of implantation. Level of evidence Level IV, retrospective case series.

scholarly journals Analysis of complications of reverse total shoulder arthroplasty

Joints ◽  
2015 ◽  
Vol 03 (02) ◽  
pp. 62-66 ◽  
Author(s):  
Raffaele Russo ◽  
Giuseppe Rotonda ◽  
Michele Ciccarelli ◽  
Fabio Cautiero
Keyword(s):  
Shoulder Arthroplasty ◽  
Constant Score ◽  
Total Shoulder Arthroplasty ◽  
Case Series ◽  
Reverse Total Shoulder Arthroplasty ◽  
Fracture Group ◽  
Long Thoracic Nerve ◽  
Secondary Osteoarthritis ◽  
Humeral Component ◽  
Reverse Total Shoulder

Purpose: the aim of this study was to analyze complications of reverse total shoulder arthroplasty (RTSA) used to treat different shoulder diseases. Methods: from March 2000 to March 2013, 195 RTSA were implanted by the senior Author. The indications for reverse prosthesis surgery were secondary osteoarthritis (OA) in 49 cases, irreparable rotator cuff tear (RCT) in 48 cases, and complex humeral fractures in 75 cases, while 19 were patients requiring surgical revision for first prosthesis implant. We used different prostheses with different designs. Results: the clinical and radiological results of all the patients were analyzed retrospectively at an average follow-up of 7 years. The cases were divided into four groups on the basis of the diagnosis and complications were classified as perioperative, postoperative, or late. The mean total Constant score improved from 28 to 69 points in the OA group; from 21 to 70.8 points in the irreparable RCT group, to 76.4 in the fracture group, and from 16.6 to 59.8 points in the revision group. Scapular notching was observed in 59 cases (30.2%). Thirty-three other complications (16.9%) were observed, namely: hematomas (n=3), instability of the humeral component (n=1), scapular spine fractures (n=2), ulnar nerve deficit (n=2), long thoracic nerve palsy (n=2), deep infections (n=2), periprosthetic fractures (n=6), glenoid fractures (n=2), implant loosening (n=2), anterior deltoid muscle deficiency (n=2) and periarticular heterotopic calcifications (n=9). Conclusions: the rates of complications, especially fractures, reported in the present study were lower than those reported in the current literature. Level of evidence: Level IV, therapeutic case series.

The incidence of radiographic aseptic loosening of the humeral component in reverse total shoulder arthroplasty

2015 ◽  
Vol 24 (10) ◽  
pp. 1555-1559 ◽  
Author(s):  
Gregory Gilot ◽  
Andres M. Alvarez-Pinzon ◽  
Thomas W. Wright ◽  
Pierre-Henri Flurin ◽  
Michael Krill ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Humeral Component ◽  
Reverse Total Shoulder
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