Medium term results of reverse total shoulder replacement in patients with rotator cuff arthropathy

Sayana, Murali Krishna; Kakarala, Gopikrishna; Bandi, Surendra; Wynn-Jones, C.

doi:10.1007/s11845-008-0262-8

Cited by 17 publications

(15 citation statements)

References 12 publications

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“…All studies that reported this outcome measure showed a remarkably consistent improvement at a mean of 41.62 (range 39 to 46) points. This is comparable with studies looking at RSA in cuff tears (mean improvement of 43) [19,41,42] or cuff arthropathy (mean improvement of 41.33) [43][44][45] and suggests that outcome from RSA in RA is predictable.…”

Section: Discussionsupporting

confidence: 79%

Reverse Shoulder Arthroplasty in Rheumatoid Arthritis: A Systematic Review

Gee¹,

Hanson²,

Saithna³

et al. 2015

Open Orthopaedics J

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Abstract:Background: Anatomical shoulder replacement for rheumatoid arthritis (RA) is complicated by a high incidence of rotator cuff tears and glenoid erosion. This can lead to poor function and early failure. Reverse shoulder arthroplasty (RSA) has gained popularity as an alternative. This systematic review attempts to further define the role of RSA in RA.Methods: A systematic review identified seven studies reporting outcomes of RSA in RA patients. Studies were critically appraised, and data on outcomes, complications and technical considerations were extracted and analysed.Results: One hundred and twenty one shoulders were included (mean follow up 46.9 months). Consistent improvements in the main outcome measures were noted between studies. Ninety five percent of patients described excellent to satisfactory outcomes. The minimum mean forward elevation reported in each study was 115 degrees. Symptomatic glenoid loosening (1.7%), deep infection (3.3%) and revision surgery (5%) rates were no higher than for a population of mixed aetiologies.Discussion: Previous concerns regarding high pre-and peri-operative complication and revision rates in RA patients were not shown to be valid by the results of this review. Although associated cuff tears are common and glenoid bone loss can increase the technical complexity of surgery, RSA provides consistent and predictable improvements in key outcome measures and the revision and complication rates do not appear to be higher than reported in a large population of mixed aetiologies. Conclusion:The contemporary literature shows that RSA is a safe, effective and reliable treatment option in RA patients.

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Section: Discussionsupporting

confidence: 79%

Reverse Shoulder Arthroplasty in Rheumatoid Arthritis: A Systematic Review

Gee¹,

Hanson²,

Saithna³

et al. 2015

Open Orthopaedics J

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“…The 155 prosthesis is certainly the most widely accepted inclination angle and has been essentially the only prosthesis used in Europe for more than 10 years. 5,12,[16][17][18]20,26,28 An inclination of 155 is theorized to improve joint stability, and further, functionally lengthens the deltoid, improving one's ability to perform forward elevation-based tasks without an intact rotator cuff. 6 However, this inclination is associated with a higher rate of scapular notching, which may be associated with midterm to long-term prosthesis failure.…”

Section: Discussionmentioning

confidence: 99%

The influence of humeral head inclination in reverse total shoulder arthroplasty: a systematic review

Erickson

Frank

Harris

et al. 2015

Journal of Shoulder and Elbow Surgery

130

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“…Delta III, Delta xtend, Tornier, etc. ), scapular notching has been reported as occurring in anywhere from 25% to 96% of patients 2,3,9,11,15,23–26,30,31 . The temporal progression of the severity of scapular notching still remains unclear.…”

Section: Discussionmentioning

confidence: 99%

“…In short term studies, favorable results have been reported with respect to pain and function 2,3,8,9,11,23,24,26,30 . The potential for ultra high molecular weight polyethylene (hereafter referred to as polyethylene) wear is substantial, given the relatively large surface area of contact.…”

Section: Introductionmentioning

confidence: 99%

Polyethylene wear in retrieved reverse total shoulder components

Day

MacDonald

Olsen

et al. 2012

Journal of Shoulder and Elbow Surgery

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Background Reverse total shoulder arthroplasty has been used to treat rotator cuff tear arthropathy, proximal humeral fractures and for failed conventional total shoulder prostheses. It has been suggested that polyethylene wear is potentially higher in reverse shoulder replacements than in conventional shoulder replacements. The modes and degree of polyethylene wear have not been completely elucidated. The purpose of this study was to evaluate polyethylene wear patterns in seven specimens retrieved at revision arthroplasty and identify factors that may be associated with increased wear. Methods Reverse total shoulder components were retrieved from 7 patients during revision arthroplasty for loosening and/or pain. Pre-operative glenoid tilt and placement, and scapular notching were evaluated using pre-operative radiographs. Polyethylene wear was evaluated using microCT and optical microscopy. Results Wear on the rim of the polyethylene humeral cup, was identified on all retrieved components. The extent of rim wear varied from a penetration depth of 0.1 to 4.7 mm. We could not demonstrate a correlation between scapular notching and rim wear. However, rim wear was more extensive when the inferior screw had made contact with the liner. Metal on metal wear between the humeral component and the inferior screw of one component was also observed. Wear of the intended bearing surface was minimal. Discussion Rim damage was the predominant cause of polyethylene wear in our retrieved specimens. Direct contact between the humeral component and inferior metaglene screws is concerning because this could lead to accelerated UHMWPE wear and also induce mechanical loosening of the glenoid component.

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Medium term results of reverse total shoulder replacement in patients with rotator cuff arthropathy

Cited by 17 publications

References 12 publications

Reverse Shoulder Arthroplasty in Rheumatoid Arthritis: A Systematic Review

Reverse Shoulder Arthroplasty in Rheumatoid Arthritis: A Systematic Review

The influence of humeral head inclination in reverse total shoulder arthroplasty: a systematic review

Polyethylene wear in retrieved reverse total shoulder components

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