Clinical and radiological outcomes of reverse shoulder arthroplasty for acute fracture in the elderly

Sabah, Yann; Decroocq, Lauryl; Gauci, Marc-Olivier; Bonnevialle, Nicolas; Lemmex, Devin B.; Chelli, Mikaël; Valenti, Philippe; Boileau, Pascal

doi:10.1007/s00264-021-05050-0

Cited by 6 publications

(10 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The unreliable results achieved with HA in the elderly suffering from cPHFs led to attempts to treat these patients with RSA, since the functional outcomes are less dependent on tuberosity healing and cuff integrity [ 13 – 15 , 19 , 20 , 44 , 45 ]. However, recent studies have demonstrated that although tuberosity healing is not a prerequisite for a satisfactory outcome after RSA for cPHFs, it still leads to better clinical results [ 21 – 27 , 46 , 47 ]. It has been proven that tuberosity osteotomy or excision is associated with worse functional results, with particular reference to a loss of external rotation and to a higher risk of RSA instability [ 27 , 48 ].…”

Section: Discussionmentioning

confidence: 99%

A novel “7 sutures and 8 knots” surgical technique in reverse shoulder arthroplasty for proximal humeral fractures: tuberosity healing improves short-term clinical results

Troiano,

Peri,

Calò

et al. 2023

J Orthop Traumatol

View full text Add to dashboard Cite

Background Complex proximal humeral fractures (cPHFs) represent an important public health concern, and reverse shoulder arthroplasty (RSA) has emerged as a feasible treatment option in the elderly with high functional demands. Recent studies have shown that tuberosity healing leads to better clinical outcomes and an improved range of motion. However, the best surgical technique for the management of the tuberosities is still a topic of debate. The purpose of this retrospective observational study is to report the radiographic and clinical outcomes of a consecutive series of patients who underwent RSA for cPHFs using a novel “7 sutures and 8 knots” technique. Materials and methods A consecutive series of 32 patients (33 shoulders) were treated with this technique by a single surgeon from January 2017 to September 2021. Results at a minimum follow-up of 12 months and a mean ± SD follow-up of 35.9 ± 16.2 (range 12–64) months are reported. Results The tuberosity union rate was 87.9% (29 out of 33 shoulders), the mean Constant score was 66.7 ± 20.5 (range 29–100) points, and the mean DASH score was 33.4 ± 22.6 (range 2–85) points. Conclusions The “7 sutures and 8 knots” technique, which relies on three sutures around the implant and five bridging sutures between the tuberosities, is a relatively simple procedure which provides a reliable means for anatomic restoration of the tuberosities and allows functional recovery of the shoulder in elderly patients with cPHFs treated with RSA. Level of evidence: IV; retrospective atudy. Trial registration: At our institution, no institutional review board nor ethical committee approval is necessary for retrospective studies.

show abstract

Section: Discussionmentioning

confidence: 99%

A novel “7 sutures and 8 knots” surgical technique in reverse shoulder arthroplasty for proximal humeral fractures: tuberosity healing improves short-term clinical results

Troiano,

Peri,

Calò

et al. 2023

J Orthop Traumatol

View full text Add to dashboard Cite

show abstract

“…An overall tuberosity healing rate of 68% was recently described in a meta-analysis [36]. Patients with anatomical tuberosity healing not only have an increased range of active anterior elevation and external rotation, but also experience fewer complications and longer prosthesis survival [37][38][39][40]. Biomechanically, a considerable drop in the joint reaction forces on the shoulder occurs with tuberosity non-union [41].…”

Section: Importance Of Tuberosity Healing On Functionmentioning

confidence: 99%

Prosthesis Designs and Tuberosity Fixation Techniques in Reverse Total Shoulder Arthroplasty: Influence on Tuberosity Healing in Proximal Humerus Fractures

Borbas

Grubhofer

et al. 2021

JCM

View full text Add to dashboard Cite

Reverse total shoulder arthroplasty (RTSA) is increasingly used for the treatment of complex proximal humerus fractures and fracture sequelae. In 2021, half a dozen models of fracture stems are commercially available, reflecting its growing utility for fracture management. Prosthesis designs, bone grafting and tuberosity fixation techniques have evolved to allow better and more reliable fixation of tuberosities and bony ingrowth. Patients with anatomical tuberosity healing not only have an increased range of active anterior elevation and external rotation, but also experience fewer complications and longer prosthesis survival. This review provides an overview of recent evidence on basic and fracture-specific RTSA design features as well as tuberosity fixation techniques that can influence tuberosity healing.

show abstract

“…Reverse shoulder arthroplasty (RSA) became one of the most efficient surgical options when treating complex PHF [3][4][5]. The RSA design medializes and lowers the center of rotation [2].…”

Section: Introductionmentioning

confidence: 99%

“…Studies reported a wide range of tuberosity healing rate [14]. Anatomic healing of the greater tuberosity (GT) was associated with better functional outcomes such as better range of motion (ROM) and shoulder function such as lower complication rates [2,4,5,15,16]. Other studies excised the tuberosities in RSA [17,18].…”

Section: Introductionmentioning

confidence: 99%

Clinical and radiological outcome following trauma-related reverse shoulder arthroplasty

Fischer,

Lohr,

Ziegler

et al. 2024

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

Background Reverse shoulder arthroplasty (RSA) is a frequently used therapy for complex proximal humeral fractures and posttraumatic disorders. The present study’s purpose was to assess the clinical and radiological outcome of primary and secondary RSA, and to analyze the impact of refixation of the greater tuberosity (GT). Patients and methods 28 patients with primary fracture RSA and 18 patients with RSA due to posttraumatic disorders were examined with a mean clinical follow-up of 2.5 ± 1.73 years. Operative details and radiographs were retrospectively reviewed. Additional analyses were performed for healed and non-healed GT in primary RSA. Results Patients with fracture RSA had higher Constant-Murley score (CMS) than secondary RSA without reaching significance (p = 0.104). No significant difference was present for the quality of life measured by the Short Form 36 (SF 36) and the range of motion. In primary RSA, 78.6% GT healed anatomically. Compared to non-healed GT, patients with healed GT had a significantly higher CMS (p = 0.011), external rotation (p = 0.026) and forward flexion (p = 0.083), whereas DASH score was lower without a significant difference (p = 0.268). SF 36 showed no significant difference. Patients with healed GT had a more neutral glenoid version (p = 0.009). Conclusion Superior range of motion and clinical outcome scores were present for anatomically healed GT. Therefore, refixation of the tuberosities is recommended. Secondary RSA can result in inferior results compared to primary RSA, so patients need to be adequately informed.

show abstract

Clinical and radiological outcomes of reverse shoulder arthroplasty for acute fracture in the elderly

Cited by 6 publications

References 20 publications

A novel “7 sutures and 8 knots” surgical technique in reverse shoulder arthroplasty for proximal humeral fractures: tuberosity healing improves short-term clinical results

A novel “7 sutures and 8 knots” surgical technique in reverse shoulder arthroplasty for proximal humeral fractures: tuberosity healing improves short-term clinical results

Prosthesis Designs and Tuberosity Fixation Techniques in Reverse Total Shoulder Arthroplasty: Influence on Tuberosity Healing in Proximal Humerus Fractures

Clinical and radiological outcome following trauma-related reverse shoulder arthroplasty

Contact Info

Product

Resources

About