Bipolar Shoulder Arthroplasty

Lee, Donald H.; Niemann, Kurt M. W.

doi:10.1097/00003086-199407000-00017

Cited by 33 publications

(22 citation statements)

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“…Especially bipolar prosthesis with large heads was thought to centralise joints with cuff insufficiency [16]. It can be used as a surgical alternative in RA patients, but many researchers recommend it only when the coracoacromial arch is intact [3,12,15,20]. However, complications, e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the treatment of the damaged cuff is considered to be very challenging [8,12,13,23]. Total shoulder replacement has been shown to fail due to early glenoid loosening [3,7,18,23,25].…”

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confidence: 99%

“…Total shoulder replacement has been shown to fail due to early glenoid loosening [3,7,18,23,25]. Hemi-arthroplasty, including bipolar prosthesis and surface replacement, provides partial pain relief but poor functional results [3,7,8,12,19,20,25]. In the treatment of RCTA, reverse total prosthesis, such as those developed by Grammont et al have been used recently [2,6,11].…”

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confidence: 99%

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Short-term results after reversed shoulder arthroplasty (Delta III) in patients with rheumatoid arthritis and irreparable rotator cuff tear

John

Pap

Angst

et al. 2009

International Orthopaedics (SICOT)

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The purpose of this study was to describe the outcome after reversed Delta III shoulder prosthesis in patients with rheumatoid arthritis (RA) and irreparable rotator cuff tear. Fifteen patients (17 joints) were prospectively analysed using the Constant-Murley score (CS). Comprehensive outcome measure was carried out by means of four widely used questionnaires as well as clinical and radiographic examinations at an average of 24.3 months postoperatively. The CS improved significantly from 19 to 59.5 points. The mental (MSC) and physical (PCS) component summary score of the Short Form 36 (SF-36) reached 108% and 77%, respectively, while the DASH (Disabilities of the Arm, Shoulder, and Hand) was 58% of a comparative norm population. Remaining deficits were documented by SPADI (Shoulder Pain and Disability; 54.4 points) and ASES (clinical and patient-orientated American Shoulder and Elbow Surgeons; 84.3 and 61.3 points, respectively). No radiological signs of loosening were found, but scapular notching occurred in four cases.Reversed arthroplasty provides a substantial improvement of shoulder function in patients with RA. The high incidence of notching is of concern.Resume Résultats à court terme de la prothèse inversée de type Delta III chez les patients porteurs d'une arthrite rhumatoïde et d'une lésion irréparable de la coiffe. Objectif: décrire le devenir du patient après mise en place d'une prothèse d'épaule inversée type Delta III, chez les patients présentant une arthrite rhumatoïde (RA) et des lésions irréparables de la coiffe. Méthode: 15 patients (17 articulations) ont été analysés de façon prospective en utilisant le score de Constant Murley (CS). Le devenir clinique des patients a été exploré grâce à 4 questionnaires utilisés communément tant sur le plan clinique que radiographique avec un examen en moyenne à 24,3 mois post-opératoires. Résultats: le score de Constant a été amélioré de façon significative passant de 19 à 59,5 points. Le score MCS et PCS ainsi que le score SF-36 sont passés respectivement de 108 à 77%, le score DASH à 58% comparables à la norme de la population. Les déficits résiduels ont été randomisés par le score SPADI 54,4 points et ASES respectivement de 84,3 à 61,3 points. Aucun signe radio de descellement mais 4 cas d'encoche scapulaire ont été relevés. En conclusion, la prothèse inversée d'épaule permet d'avoir une amélioration très substantielles chez les patients présentant une arthrite rhumatoïde. La fréquence importante des encoches est à surveiller.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Short-term results after reversed shoulder arthroplasty (Delta III) in patients with rheumatoid arthritis and irreparable rotator cuff tear

John

Pap

Angst

et al. 2009

International Orthopaedics (SICOT)

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“…Some provide a numerical scale to enable statistical comparisons; others are only guidelines for a comprehen-arthroplasty to improve the strength of a patient, but to achieve pain relief and enable basic functions so that the patient will master the activities of daily living (Neer 1970, 1974, Neer et al 1982). According to de Leest et al (1996), strength after shoulder arthroplasty is dependent on the orientation of the glenoid, the radius of the humeral head, and the position of the geometric center of the glenohumeral joint in relation to the scapula and in relation to the humeral shaft (Lee and Niemann 1994). Experimental changes to the geometric center in relation to the humeral shaft can cause differences in force of up to 300%.…”

Section: Radiographic Resultsmentioning

confidence: 99%

“…Since few authors present absolute figures of their patients' assessments, a comparison against other results cannot easily be performed Lee and Niemann (1994), Neer et al (1982),. Sperling et al (1988) evaluated patients less than 50 years of age with the modified Neer score.…”

Section: Radiographic Resultsmentioning

confidence: 99%

Outcome assessment of hemiarthroplasty of the shoulder: A 5-year follow-up with 4 evaluation tools

2006

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BackgroundOutcome measurement of shoulder arthroplasty is not standardized. We compared 3 scores and 1 evaluation form.Patients and methods We report on 35 hemiarthroplasties of the shoulder (32 cementless). Mean age of the patients was 62 (29-87) years. After a mean follow-up of 6 years (range 2-18 years) patients were evaluated with the Neer score, the Constant-Murley score, the score of the University of California in Los Angeles (UCLA) and the Society of Shoulder and Elbow Surgeons Basic Shoulder Evaluation Form. We also performed radiographic evaluation and sonographic evaluation of the rotator cuff.Results Although pain relief and patient satisfaction were promising, the overall results of the respective score showed low values (Neer score 56/100 points, Constant-Murley score 43/100 points, and UCLA score 19/35 points on average).Interpretation We recommend choice of a score with a high impact of pain and patient satisfaction. Furthermore, ability to cope with activities of daily living should be of more importance than strength.

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Differentialtherapie der rheumatischen Schulter

Schill

Thabe²,

Grifka³

2002

Der Orthop�de

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Despite frequent involvement, the rheumatoid shoulder is neglected in operative treatment of the upper extremities. The slow course of omarthritis, the compensation mechanism of scapulothoracic motion and neighbouring joints as well as dominating disabilities of the lower extremities and the rheumatoid hand are possible explanations. The pattern of destruction of the rheumatoid shoulder is characterized by progressive joint and soft tissue deterioration. Soft tissue involvement determines the course of the shoulder joint. The subacromial space is a common and early site for rheumatoid involvement, often leading to bursitis, tenosynovitis of the biceps tendon and rotator cuff rupture. Sonography and MRI enable the early detection of subacromial and glenohumeral pathology before deterioration is visible radiologically. Surgical intervention in patients with rheumatoid arthritis of the shoulder is based on the degree of radiological destruction according to Larsen, the natural course of the shoulder joint and the soft-tissue condition. The goals of surgery are to relieve pain, increase motion and restore shoulder function. Surgery should be carried out early in the course of the disease, thus determining the long-term prognosis and the remaining surgical options. Depending on the pattern of destruction of the rheumatoid shoulder, the options for treatment can be divided into early and late procedures.Joint-preserving surgery is indicated in the early stages of radiological destruction according to Larsen classification O-III, whereas the late stages of destruction (Larsen IV-V) require reconstructive surgery. The introduction of arthroscopic and semiarthroscopic techniques has improved the acceptance of early synovectomy for the rheumatoid shoulder, but there is still a place for open synovectomy in patients with extensive soft-tissue repair and bone-remodelling procedures. Arthroscopic and open synovectomy are supplementary and noncompetitive surgical procedures for the rheumatoid shoulder. With proceeding bone and soft-tissue destruction corresponding to Larsen stage IV and V, synovectomy is not successful and reconstructive surgery is necessary. Resection-interposition-arthroplasty (RAIP) remains a controversial alternative to arthroplasty in young patients with sufficient bone stock and a reconstructable rotator cuff. The success of cup-replacement will additionally restrict the indications for RAIP. RIAP remains a possible salvage procedure after aseptic and septic loosening of shoulder arthroplasty. Glenohumeral replacement arthroplasty has become the procedure of choice in reconstructive surgery of the shoulder. The severity of soft-tissue and bone destruction determines the choice of shoulder prosthesis. Current modular shoulder systems with increased numbers of humeral-head stem combinations are calculated to achieve a better adjustment of the soft-tissue tension and to optimize the adaptation between head geometry and the natural shape of the glenoid.The surrounding soft-tissue structure, especially the co...

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Bipolar Shoulder Arthroplasty

Cited by 33 publications

References 0 publications

Short-term results after reversed shoulder arthroplasty (Delta III) in patients with rheumatoid arthritis and irreparable rotator cuff tear

Short-term results after reversed shoulder arthroplasty (Delta III) in patients with rheumatoid arthritis and irreparable rotator cuff tear

Outcome assessment of hemiarthroplasty of the shoulder: A 5-year follow-up with 4 evaluation tools

Differentialtherapie der rheumatischen Schulter

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