Acromial and spine fractures after reverse arthroplasty: Prevalence and risk factors

Marigi, Erick M.; Bartels, D; Tangtiphaiboontana, Jennifer; Ivanov, David; Nguyen, Ngoc-Tram; Sánchez-Sotelo, Joaquín

doi:10.1053/j.sart.2020.07.006

Cited by 8 publications

(8 citation statements)

References 19 publications

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“…According to Schenk et al 6 , the incidence is 0.3% for type I, 1.7% for type II, and 0.6% for type III. Other studies report Crosby type II and III fractures at similar incidence between 0.6% and 0.8% 2, 18 .…”

Section: Crosby Classificationmentioning

confidence: 83%

“…Because the inter-rater reliability is higher than that of the Crosby system, the Levy system is more commonly used in reporting acromial and SS fracture regions 10,11,15,16 . Type I and II fractures occur with similar frequency (range, 0.2%-1.3% and 0.3%-2.0%, respectively 2,13,17,18,20 ) and type III fractures with less frequency (0%-0.8%) 21 .…”

Section: Classification Systemsmentioning

confidence: 93%

“…Previous acromioplasty of the operative shoulder has been proposed as an unclear risk factor of acromial fractures after RSA 21 . Marigi et al 18 studied 2,172 shoulders including 36 SS fractures and found a trend toward increased SS fractures with prior acromioplasty (36% vs. 3%, p = 0.070). However, significance was not found on multivariable analysis (hazard ratio, 2.55, p = 0.07), leading the authors to hypothesize confounding with female patients with osteopenia.…”

Section: Patient Risk Factorsmentioning

confidence: 99%

“…Body mass index (BMI) has not been reported as a risk factor of acromial and SS fractures 8,13,14,17,18,26,33 . However, all of these studies investigated this variable in a linear manner or between fracture and non-fracture groups rather than on an ordinal, categorical scale 8,13,14,17,18,26,33 . The relationship between BMI and acromion and SS fractures after RSA is unclear.…”

Section: Patient Risk Factorsmentioning

confidence: 99%

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Mitigating Fracture of the Acromion and Scapular Spine After Reverse Shoulder Arthroplasty

Buchanan,

Bindi,

Caban-Klepac

et al. 2023

JBJS Reviews

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» Biomechanical studies report that thin scapular spine (SS) morphology, superiorly placed glenoid components, and increased glenoid baseplate screws contribute to increased acromial and SS strain and may increase fracture risk. » Clinical risk factors of acromial and SS fractures after reverse shoulder arthroplasty include increasing age, female sex, osteoporosis, rheumatoid arthritis, thin midsubstance acromion morphology, previous acromioplasty, and surgical indication of cuff tear arthropathy. » Clinical studies show that, in isolation, excessive humeral lengthening, humeral lateralization, and glenoid medialization may increase risk of acromial and SS fractures. » Biomechanical studies suggest that a combination of glenoid medialization and humeral lateralization (MG/LH) may reduce fracture risk, although this requires clinical correlation. » Surgeons might reduce fracture risk in patients of high-risk groups by guarding against excessively lengthening the humerus, using a MG/LH prosthesis, and targeting screws to avoid the scapular notch and base of the SS. Level of Evidence: Level V. Narrative Review. See Instructions for Authors for a complete description of levels of evidence.

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Section: Crosby Classificationmentioning

confidence: 83%

Section: Classification Systemsmentioning

confidence: 93%

Section: Patient Risk Factorsmentioning

confidence: 99%

Section: Patient Risk Factorsmentioning

confidence: 99%

See 2 more Smart Citations

Mitigating Fracture of the Acromion and Scapular Spine After Reverse Shoulder Arthroplasty

Buchanan,

Bindi,

Caban-Klepac

et al. 2023

JBJS Reviews

View full text Add to dashboard Cite

show abstract

“…Stress fractures of the scapular spine and acromion classically manifest as acute onset of pain a few months after an RSA. 47 Any correlation between pain and activity is important too: pain at rest may be indicative of infection or neuropathic pain, whereas pain with activity may be related to mechanical causes such as implant loosening or painful glenoid erosion after hemiarthroplasty.…”

Section: Evaluation Of the Painful Shoulder Arthroplastymentioning

confidence: 99%