Delta Shoulder Prosthesis for Rotator Cuff Rupture

Grammont, P; Baulot, Emmanuel

doi:10.3928/0147-7447-19930101-11

Cited by 640 publications

(240 citation statements)

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“…Reverse shoulder arthroplasty was initially described by Grammont 15 , and is principally indicated in cases of glenohumeral arthritis associated with instability as a result of a functionally or anatomically deficient rotator cuff in the elderly 2, 13, 16, 22 ; however, our data shows that the concomitant diagnosis of osteoarthritis and rotator cuff disorder was coded in only 29.8% of cases undergoing reverse shoulder arthroplasty. This is likely because the indications for reverse shoulder arthroplasty have expanded to include isolated large rotator cuff tears, proximal humeral fractures, cases of revision arthroplasty, and younger patients 5, 25, 26 .…”

Section: Discussionmentioning

confidence: 63%

The contribution of reverse shoulder arthroplasty to utilization of primary shoulder arthroplasty

Jain

Yamaguchi

2014

Journal of Shoulder and Elbow Surgery

122

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Background We assessed the contribution of reverse shoulder arthroplasty to overall utilization of primary shoulder arthroplasty, and present age and sex stratified national rates of shoulder arthroplasty. We also assessed contemporary complication rates, mortality, and indications for shoulder arthroplasty, as well as estimates and indications for revision arthroplasty. Methods We used the Nationwide Inpatient Samples for 2009–2011 to calculate estimates of shoulder arthroplasty and assessed trends using joinpoint regression. Results The cumulative estimated utilization of primary shoulder arthroplasty (total anatomical, hemi, and reverse) increased significantly from 52,397 procedures (95% CI=47,093–57,701) in 2009 to 67,184 cases (95% CI=60,638–73,731) in 2011. Reverse shoulder arthroplasty accounted for 42% of all primary shoulder arthroplasty procedures in 2011. The diagnosis of concomitant diagnosis of osteoarthritis and rotator cuff impairment was found in only 29.8% of reverse shoulder arthroplasty cases. The highest rate of reverse shoulder arthroplasty was in the 75–84 year female sub-group (77; 95% CI=67–87). Revision cases were 8.8% and 8.2% of all shoulder arthroplasties in 2009 and 2011, respectively, and 35% of revision cases were secondary to mechanical complications/loosening while 18% were due to dislocation. Conclusions The utilization of primary shoulder arthroplasty significantly increased in just a three year time span, with a major contribution from reverse shoulder arthroplasty in 2011. Indications appear to have expanded as a large percentage of patients did not have rotator cuff pathology. The burden from revision arthroplasties was also substantial and efforts to optimize outcomes and longevity of primary shoulder arthroplasty are needed. Level of evidence Epidemiology Study, Database Analysis

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Section: Discussionmentioning

confidence: 63%

The contribution of reverse shoulder arthroplasty to utilization of primary shoulder arthroplasty

Jain

Yamaguchi

2014

Journal of Shoulder and Elbow Surgery

122

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“…Although RTSA provides pain relief in most patients, its associated rate and variety of complications are higher than those for anatomical total shoulder arthroplasty[1,2]. …”

Section: Introductionmentioning

confidence: 99%

“…One is a Grammont-type prosthesis, which has a center of rotation at the level of the glenoid where the baseplate meets the bone[1]. The other, available from various manufacturers, has a center of rotation in a more lateral position, which theoretically increases the shear forces across the baseplate-to-glenoid bone interface[3].…”

Section: Introductionmentioning

confidence: 99%

Prosthetic design of reverse shoulder arthroplasty contributes to scapular notching and instability

Huri¹,

Familiari²,

Salari³

et al. 2016

WJO

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AIMTo evaluate whether implant design, glenoid positioning, and other factors influenced instability and scapular notching in reverse total shoulder arthroplasty.METHODSWe retrospectively reviewed records of patients who had undergone reverse total shoulder arthroplasty by the senior author from July 2004 through October 2011 and who had at least 24 mo of follow-up. The 58 patients who met the criteria had 65 arthroplasties: 18 with a Grammont-type prosthesis (Grammont group) and 47 with a lateral-based prosthesis (lateral-design group). We compared the groups by rates of scapular notching and instability and by radiographic markers of glenoid position and tilt. We also compared glenoid sphere sizes and the number of subscapularis tendon repairs between the groups. Rates were compared using the Fisher exact test. Notching severity distribution was compared using the χ2 test of association. Significance was set at P < 0.05.RESULTSThe Grammont group had a higher incidence of scapular notching (13 of 18; 72%) than the lateral-design group (11 of 47; 23%) (P < 0.001) and a higher incidence of instability (3 of 18; 17%) than the lateral-design group (0 of 47; 0%) (P = 0.019). Glenoid position, glenoid sphere size, and subscapularis tendon repair were not predictive of scapular notching or instability, independent of implant design. With the lateral-based prosthesis, each degree of inferior tilt of the baseplate was associated with a 7.3% reduction in the odds of developing notching (odds ratio 0.937, 95%CI: 0.894-0.983).CONCLUSIONThe lateral-based prosthesis was associated with less instability and notching compared with the Grammont-type prosthesis. Prosthesis design appears to be more important than glenoid positioning.

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“…1,2 Over time, indications of RSA were expanded to other conditions with various degrees of cuff deficiency, such as irreparable rotator cuff tears without osteoarthritis, 3 inflammatory arthritis, 4 fracture sequelae, 5 tumour resection, 6 failed hemiarthroplasty after fracture, 7 failed hemiarthroplasty with cuff deficiency, 8 failure after total shoulder arthroplasty 9 and deep infection. 10 Other indications now include the treatment of complex fractures of the proximal humerus in the elderly, 11 as well as osteoarthritis with posterior subluxation and a biconcave glenoid.…”

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confidence: 99%

Complications in reverse shoulder arthroplasty

et al. 2016

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The reported rate of complications of reverse shoulder arthroplasty (RSA) seems to be higher than the complication rate of anatomical total shoulder arthroplasty.The reported overall complication rate of primary RSA is approximately 15%; when RSA is used in the revision setting, the complication rate may approach 40%.The most common complications of RSA include instability, infection, notching, loosening, nerve injury, acromial and scapular spine fractures, intra-operative fractures and component disengagement.Careful attention to implant design and surgical technique, including implantation of components in the correct version and height, selection of the best glenosphere-humeral bearing match, avoidance of impingement, and adequate management of the soft tissues will hopefully translate in a decreasing number of complications in the future.Cite this article: Barco R, Savvidou OD, Sperling JW, Sanchez-Sotelo J, Cofield RH. Complications in reverse shoulder arthroplasty. EFORT Open Rev 2016;1:72-80. DOI: 10.1302/2058-5241.1.160003.

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Delta Shoulder Prosthesis for Rotator Cuff Rupture

Cited by 640 publications

References 1 publication

The contribution of reverse shoulder arthroplasty to utilization of primary shoulder arthroplasty

The contribution of reverse shoulder arthroplasty to utilization of primary shoulder arthroplasty

Prosthetic design of reverse shoulder arthroplasty contributes to scapular notching and instability

Complications in reverse shoulder arthroplasty

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