Long-term outcome of shoulder arthrodesis performed with plate fixation: 18 patients examined after 3–15 years

Abstract

Background and purpose There have been few reports on the long-term function after shoulder arthrodesis. We report the outcome after shoulder arthrodesis with plate fixation in 18 patients who were followed for 3-15 years.Methods 25 patients with a median age of 64 (19-75) years were operated with a shoulder arthrodesis between 1982 and 2003. Standard AO surgical technique with plating was used in all patients. 18 of the patients were examined retrospectively after a mean of 8 (3-15) years. 6 of the other patients had died and 1 refused examination.Results Radiologically, all but two arthrodeses fused completely. The remaining two were partially fused, within the glenohumeral joint or between humerus and acromion. The mean Oxford shoulder score was 32 and the mean ASES shoulder index was 59. Nine patients had intermittent or continuous pain; their mean pain score on a visual analog scale was 3. One patient had been re-operated after 4 months because of severe pain and 1 was operated due to a humeral shaft fracture after 8 months. 1 patient suffered from a complex regional pain syndrome. No infections occurred.Interpretation In this patient series there were few complications after shoulder arthrodesis, and the longterm functional results were acceptable.

Indication, Technique and Long-term Results after Shoulder Arthrodesis Performed with Plate Fixation

“…The values are within the same range as reported by Esenyel et al, whose patients attained 35.9 points [19]. Both Dimme et al and Tharangajah et al reported values of 32 points [2,5]. The SSV compares the diseased or operated shoulder with a fully healthy shoulder, which is given a value of 100 % [14].…”

“…Depending on the surgical procedure, this may be as common as 40 %, and secondary correction of the position may sometimes be necessary [2,4,17,18,30]. Other complications in- clude infections, periarticular fractures, painful implant conflicts, and malposition [2,19]. There are also published reports of neural lesions, haematomas, pneumothorax, implant fracture, and CRPS (complex regional pain syndrome) [4].…”

Shoulder arthrodesis with a reconstruction plate

“…Postoperative infections have been reported in 0~14% of shoulder arthrodeses [7,9,15,19]. In our cases, we routinely used prophylactic antibiotics and did not experience any infections.…”

The use of the reverse shoulder arthroplasty for treatment of failed total shoulder arthroplasty

“…Among the salvage procedures that can be performed are resection arthroplasty, conversion to hemiarthroplasty, and arthrodesis; however, these alternatives do not reliably decrease pain and restore function to the affected shoulder. 4,6,15 As an alternative, reverse shoulder arthroplasty (RSA) has been considered as another treatment option for failed TSA. RSA has been shown to be an effective treatment for other complex shoulder problems, including rotator cuff arthropathy, 21,23 failed hemiarthroplasty, 12 and proximal humerus fractures.…”