Reverse Shoulder Arthroplasty
Recently Published Documents





2021 ◽  
Vol 10 (19) ◽  
pp. 4600
Philipp A. Michel ◽  
J. Christoph Katthagen ◽  
Benedikt Schliemann ◽  
Sina Wilkens ◽  
Andre Frank ◽  

Reverse shoulder arthroplasty (RSA) is a commonly performed salvage procedure for failed proximal humeral fracture fixation. The rate of intraoperative periprosthetic fractures is higher compared to primary RSA. The goal of this study was to investigate the biomechanical value of a protective cerclage during stem impaction in a revision surgery setting. Twenty-eight fresh-frozen human humeri were used to assess different configurations for steel wire and FiberTape cerclages. A custom-built biomechanical test setup simulated the mallet strikes during the stem impaction process with the Univers Revers prothesis stem. The mallet energy until the occurrence of a first crack was not different between groups. The total energy until progression of the fracture distally to the cerclage was significantly higher in the cerclage groups compared to the native humerus (9.5 J vs. 3.5 J, respectively; p = 0.0125). There was no difference between the steel wire and FiberTape groups (11.4 J vs. 8.6 J, respectively; p = 0.2695). All fractures were located at the concave side of the stem at the metaphyseal calcar region. This study demonstrates that a protective cerclage can successfully delay the occurrence of a fracture during stem impaction in reverse shoulder arthroplasty. A FiberTape cerclage is biomechanically equally efficient compared to a steel wire cerclage.

Allen D. Nicholson ◽  
Joshua I. Mathew ◽  
Chelsea N. Koch ◽  
Andreas Kontaxis ◽  
Timothy Wright ◽  

Max Hamaker ◽  
Kali Stevens ◽  
Michael Rocca ◽  
Xuyang Song ◽  
S. Ashfaq Hasan ◽  

Siddharth Virani ◽  
Natalie Holmes ◽  
Mina Al-Janabi ◽  
Chris Watts ◽  
Chris Brooks ◽  

2021 ◽  
Vol 22 (1) ◽  
Alberto Izquierdo-Fernández ◽  
Marta Gómez-Rodríguez ◽  
Maite Urbano-Luque ◽  
Manuel García-Carmona ◽  
Rafael Quevedo-Reinoso ◽  

Abstract Background There is still little information about the long-term results of clinical and radiological evolution in patients older than 65 years with complex proximal humerus fractures (CPHF) treated acutely with reverse shoulder arthroplasty (RSA). The aim of this paper was to evaluate function and results 7 years after surgery. Material and methods A prospective cross-sectional cohort study was designed for this purpose. Patients who underwent RSA surgery during 2012 because of a CPHF were included. The surgical approach was randomized (deltopectoral vs anterosuperior). Functional activity, evolution of tuberosities and evidence of scapular notching 7 years after surgery were analyzed. Results After evaluating 32 patients, the Constant score improved from 64.83 in the first year to 69.54 at 7 years postoperative. Results were independent of the approach used. Functional outcomes were poorer in patients with scapular notching and when tuberosities were resorbed or displaced. Conclusions At 7 years, function in patients undergoing RSA after CPHF demonstrated improvement in all patients except those who developed scapular notching or when tuberosities did not consolidate in an anatomical position. These results are completely independent of the approach used. Level of evidence III Controlled cohort study.

B. Gage Griswold ◽  
L. Fielding Callaway ◽  
Matthew R. I. Meng ◽  
Cameron S. Murphy ◽  
Daniel W. Paré ◽  

2021 ◽  
Vol 10 (18) ◽  
pp. 4130
Marko Nabergoj ◽  
Shinzo Onishi ◽  
Alexandre Lädermann ◽  
Houssam Kalache ◽  
Rihard Trebše ◽  

(1) Background: Postoperative recovery of external rotation after reverse shoulder arthroplasty (RSA) has been reported despite nonfunctional external rotator muscles. Thus, this study aimed to clinically determine the ideal prosthetic design allowing external rotation recovery in such a cohort. (2) Methods: A monocentric comparative study was retrospectively performed on patients who had primary RSA between June 2013 and February 2018 with a significant preoperative fatty infiltration of the infraspinatus and teres minor. Two groups were formed with patients with a lateral humerus/lateral glenoid 145° onlay RSA—the onlay group (OG), and a medial humerus/lateral glenoid 155° inlay RSA—the inlay group (IG). Patients were matched 1:1 by age, gender, indication, preoperative range of motion (ROM), and Constant score. The ROM and Constant scores were assessed preoperatively and at a minimum follow-up of two years. (3) Results: Forty-seven patients have been included (23 in OG and 24 in IG). Postoperative external rotation increased significantly in the OG only (p = 0.049), and its postoperative value was significantly greater than that of the IG by 11.1° (p = 0.028). (4) Conclusion: The use of a lateralized humeral stem with a low neck-shaft angle resulted in significantly improved external rotation compared to a medialized humeral 155° stem, even in cases of severe fatty infiltration of the infraspinatus and teres minor. Humeral lateralization and a low neck-shaft angle should be favored when planning an RSA in a patient without a functional posterior rotator cuff.

Sign in / Sign up

Export Citation Format

Share Document