Management of the Failed Arthroplasty for Proximal Humerus Fracture

Petković, Dušan; Kovacevic, David; Levine, William N.; Jobin, Charles M.

doi:10.5435/jaaos-d-17-00051

Cited by 9 publications

(11 citation statements)

References 40 publications

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“…The authors identified female sex, a history of instability, and prior hemiarthroplasty as risk factors for intraoperative periprosthetic humerus fracture [41••, 45]. Technical challenges of arthroplasty in a revision setting included loss of tissue planes, bone loss, and, at times, infection [45]. An implant-specific removal device may reduce the risk of intraoperative fracture during this step [41••].…”

Section: Risk Factorsmentioning

confidence: 99%

Periprosthetic Fractures in Reverse Total Shoulder Arthroplasty: Current Concepts and Advances in Management

Brusalis

Taylor

2020

Curr Rev Musculoskelet Med

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Purpose of Review Expanded indications for reverse total shoulder arthroplasty (RSA) have raised awareness of associated complications, including periprosthetic fractures. The purpose of this article was to provide a comprehensive update on how, when, and why RSA-related periprosthetic fractures occur, as well as to describe the current treatment strategies. Recent Findings Periprosthetic acromial and scapular spine fractures occur in up to 4.3% of cases and periprosthetic humeral fractures occur in approximately 3.5% of RSA procedures. Fractures of the coracoid process and clavicle have also been reported. Current literature has identified several risk factors for intraoperative or postoperative fracture, including underlying osteoporosis, revision arthroplasty, use of a superiorly placed screw during metaglene fixation, and disruption of the scapular ring by transection of the coracoacromial ligament. Summary Periprosthetic fracture associated with RSA is a clinically significant event that warrants prolonged postoperative vigilance, timely diagnosis, and shared patient decision-making regarding treatment. Further research is needed to identify optimal treatment strategies and characterize long-term clinical outcomes following RSA-related periprosthetic fracture.

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Section: Risk Factorsmentioning

confidence: 99%

Periprosthetic Fractures in Reverse Total Shoulder Arthroplasty: Current Concepts and Advances in Management

Brusalis

Taylor

2020

Curr Rev Musculoskelet Med

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“…Algunos de ellos causan una infección de bajo grado, silente y crónica, por lo cual al obtener un cultivo por aspiración debemos esperar hasta 21 días para descartar la formación de Propionibacterium acnes. 11…”

Section: Infeccionesunclassified

“…25 Durante la realización de estas técnicas la incidencia aproximada de fracturas humerales es de 16%, por lo que debemos estar preparados para su manejo. 11 En los casos en que el manto previo de cemento esté bien fijo al húmero, se puede utilizar la técnica «cement within cement», 26 técnica descrita por Wagner, Sperling y Sánchez-Sotelo. En esta técnica se utiliza el manto de cemento del vástago previo, solamente preparándolo con un legrado del mismo, para después poder colocar un vástago corto cementado dentro del mismo.…”

Section: Wwwmedigraphicorgmxunclassified

¿Qué hacer cuando la reversa falló? Protocolos de manejo. Revisión de alcance

Cervantes¹,

García²,

Acevedo³

2019

Ortho-Tips

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Introducción: La artroplastia reversa es en la actualidad la artroplastia de hombro con más indicaciones y capacidad de solución de problemas. De todas las artroplastias reversas de hombro (ARH) más de 50% habrán fallado a los 10 años. El objetivo de esta revisión de alcance es identificar las principales problemáticas a las cuales nos enfrentamos al tener un paciente con una prótesis reversa fallida. Material y métodos: Se realizó una revisión de alcance del tema «fallo de prótesis reversa y revisión de prótesis reversa de hombro». Debido a la reciente aparición de este tipo de problemas y a su constante cambio en el manejo, se decidió realizarla de la literatura de los últimos cinco años (diciembre de 2014 a noviembre de 2019). Resultados: Las principales causas de revisión de la ARH son inestabilidad (32%), infección (13.8%), disociación del componente glenoideo (12.2%), aflojamiento glenoideo (10.4%), aflojamiento humeral (5.5%), dificultad al poner la base glenoidea (4.8%) y dificultad al colocar la glenoesfera (4.4%). El abordaje diagnóstico www.medigraphic.com/orthotips

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“…ORIF with the use of locking plates has been implicated in complications such as malreduction, screw cutout, malunion, nonunion, avascular necrosis, and infection, 5 , 10 whereas HA is often associated with tuberosity malunion or resorption, impingement, periprosthetic fractures, loosening, infection, glenoid arthritis and chronic rotator cuff tears. 2 , 11 – 13 …”

Section: Introductionmentioning

confidence: 99%

“…For most of them RSA seems to be the only solution that can offer an opportunity for improvement in pain and function. 13 – 26 …”

Section: Introductionmentioning

confidence: 99%

Reverse Shoulder Arthroplasty for Failed Operative Treatment of Proximal Humeral Fractures

Kokkalis

Bavelou

Papanikos

et al. 2022

Journal of Shoulder and Elbow Arthroplasty

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Introduction Failure after operative treatment of complex proximal humeral fractures (PHF) can prove challenging even for experienced surgeons. Reverse shoulder arthroplasty (RSA) seems to offer a satisfactory revision procedure with good clinical outcomes. Materials and Methods We present a case series of 14 patients, who were treated during a 3.5 years period (from 01/2016 until 06/2019). They all underwent revision surgery with RSA for failed operative treatment of PHF. Their mean age was 68 years (range, 51-84 years). 2 patients (14.3%) had been primarily treated with open reduction and internal fixation (ORIF), 5 patients (35.7%) with hemiarthroplasty, 3 patients (21.4%) with closed reduction and percutaneous fixation and 4 patients (28.6%) with transosseous suture fixation (TSF). We evaluated their absolute Constant score (CS), Visual Analogue Scale (VAS) score, and Range of Motion at their final follow-up, and we made a full clinical and radiological assessment to detect any postoperative complications. Results The mean absolute CS, VAS score, active anterior elevation, active abduction significantly improved compared with the preoperative status. Less significant difference was found in external rotation when comparing with the preoperative status ( P = .0304). No significant differences were found when comparing RSA for different failed primary techniques ( P > .05). No complications were detected following the revision surgeries of all patients. Conclusion RSA is an appropriate treatment as a revision technique for failed primary surgical treatment of PHFs. Though challenging it can offer good clinical results and pain relief.

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Management of the Failed Arthroplasty for Proximal Humerus Fracture

Cited by 9 publications

References 40 publications

Periprosthetic Fractures in Reverse Total Shoulder Arthroplasty: Current Concepts and Advances in Management

Periprosthetic Fractures in Reverse Total Shoulder Arthroplasty: Current Concepts and Advances in Management

¿Qué hacer cuando la reversa falló? Protocolos de manejo. Revisión de alcance

Reverse Shoulder Arthroplasty for Failed Operative Treatment of Proximal Humeral Fractures

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