Patient risk factors for acromial stress fractures after reverse shoulder arthroplasty: a multicenter study

Moverman, Michael A.; Menendez, Mariano E.; Mahendraraj, Kuhan A.; Polisetty, Teja S.; Jawa, Andrew; Levy, Jonathan C.

doi:10.1016/j.jse.2020.09.012

Cited by 38 publications

(39 citation statements)

References 52 publications

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“…10,24,27,35 Although, the underlying causes J o u r n a l P r e -p r o o f are poorly understood, fracture occurrence deteriorates the clinical outcome. 10,28,30,33,35,36,39 Some identified risk factors were female sex 32 , osteoporosis 32,34,44 , massive rotator cuff tear as an indication for RTSA implantation or glenoid screw positioning 13,23 . The biomechanical influence of RTSA design and RTSA positioning on acromial stress remain controversial.…”

Section: Level Of Evidence: Level Iii; Retrospective Case-control Des...mentioning

confidence: 99%

Incidence, radiographic predictors, and clinical outcome of acromial stress reaction and acromial fractures in reverse total shoulder arthroplasty

Kriechling

Hodel

Paszicsnyek

et al. 2022

Journal of Shoulder and Elbow Surgery

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Section: Level Of Evidence: Level Iii; Retrospective Case-control Des...mentioning

confidence: 99%

Incidence, radiographic predictors, and clinical outcome of acromial stress reaction and acromial fractures in reverse total shoulder arthroplasty

Kriechling

Hodel

Paszicsnyek

et al. 2022

Journal of Shoulder and Elbow Surgery

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Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

“…A number of recent studies have identified patient risk factors for the development of acromial stress fracture after reverse total shoulder arthroplasty (RTSA) [19,23,34]. Interestingly, osteoporosis and female sex were found to be patient-specific risk factors for acromial stress fracture independent of RTSA [19,23,34]. Acromial stress fractures after RTSA are thought to occur as a result of altered mechanics about the shoulder as the deltoid and trapezium exert greater force on the acromion during movement to compensate for the lack of a rotator cuff [27].…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Acromion stress fracture in an elderly cane walker with Parkinson’s disease: a case report

Sudah

Kerrigan

Ruskin

2021

JSES Reviews, Reports, and Techniques

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Patient factors such as female gender, osteoporosis, or acromial anatomy have been identified as risk factors for acromial and scapular spine fractures after RTSA [28][29][30]. Implant factors, such as increased lateralization of the glenoid component, were proposed to play a significant role in increasing stress on the acromion [31,32].…”

Section: Introductionmentioning

confidence: 99%

Factors Influencing Acromial and Scapular Spine Strain after Reverse Total Shoulder Arthroplasty: A Systematic Review of Biomechanical Studies

Paszicsnyek,

Jo,

Rupasinghe

et al. 2022

JCM

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Background: Acromial and scapular spine fractures after reverse total shoulder arthroplasty (RTSA) can be devastating complications leading to substantial functional impairments. The purpose of this study was to review factors associated with increased acromial and scapular spine strain after RTSA from a biomechanical standpoint. Methods: A systematic review of the literature was conducted based on PRISMA guidelines. PubMed, Embase, OVID Medline, and CENTRAL databases were searched and strict inclusion and exclusion criteria were applied. Each article was assessed using the modified Downs and Black checklist to appraise the quality of included studies. Study selection, extraction of data, and assessment of methodological quality were carried out independently by two of the authors. Only biomechanical studies were considered. Results: Six biomechanical studies evaluated factors associated with increased acromial and scapular spine strain and stress. Significant increases in acromial and scapular spine strain were found with increasing lateralization of the glenosphere in four of the included studies. In two studies, glenosphere inferiorization consistently reduced acromial strain. The results concerning humeral lateralization were variable between four studies. Humeral component neck-shaft angle had no significant effect on acromial strain as analysed in one study. One study showed that scapular spine strain was significantly increased with a more posteriorly oriented acromion (55° vs. 43°; p < 0.001). Another study showed that the transection of the coracoacromial ligament increased scapular spine strain in all abduction angles (p < 0.05). Conclusions: Glenoid lateralization was consistently associated with increased acromial and scapular spine strain, whereas inferiorization of the glenosphere reduced strain in the biomechanical studies analysed in this systematic review. Humeral-sided lateralization may increase or decrease acromial or scapular spine strain. Independent of different design parameters, the transection of the coracoacromial ligament resulted in significantly increased strains and scapular spine strains were also increased when the acromion was more posteriorly oriented. The results found in this systematic review of biomechanical in-silico and in-vitro studies may help in the surgical planning of RTSA to mitigate complications associated with acromion and scapular spine fracture.

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Patient risk factors for acromial stress fractures after reverse shoulder arthroplasty: a multicenter study

Cited by 38 publications

References 52 publications

Incidence, radiographic predictors, and clinical outcome of acromial stress reaction and acromial fractures in reverse total shoulder arthroplasty

Incidence, radiographic predictors, and clinical outcome of acromial stress reaction and acromial fractures in reverse total shoulder arthroplasty

Acromion stress fracture in an elderly cane walker with Parkinson’s disease: a case report

Factors Influencing Acromial and Scapular Spine Strain after Reverse Total Shoulder Arthroplasty: A Systematic Review of Biomechanical Studies

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