Primary shoulder reverse arthroplasty: Surgical technique

Abstract

Total reverse shoulder replacement is now a very common surgical procedure that has been shown to be effective in the treatment of rotator cuff tear arthropathies or massive rotator cuff tears with pseudo paralysis, even without arthritis. However, the survival curves of the oldest series decrease between 8 and 10 years after arthroplasty (events: implant survival, or worsening of clinical outcome) which explains why the indication for this type of arthroplasty is usually limited to patients over seventy. Moreover, details and technical modifications have been suggested to improve the surgical technique, the quality of fixation and the mechanical conditions of this non-anatomical prosthesis to improve clinical outcome and implant survival. Within the framework of primary surgery, excluding traumatic or revision surgery, the primary indications for this option are massive rotator cuff tears with (or without) osteoarthritis and primary osteoarthritis with rotator cuff tears and/or with severe glenoid wear and finally, rheumatoid arthritis. The purpose of this conference was to assess and describe the most important preoperative criteria and surgical conditions necessary for this procedure as well as specific technical details about the surgical procedure itself based on available options and options under evaluation such as the positioning of the glenoid component (lateralization, bone graft, orientation) and the association of muscle transfers.

Risk factors associated with blood transfusion after shoulder arthroplasty

“…In the literature, several studies have reported no definitive clinical benefit with use of closed-suction drainage postoperatively, whereas many have documented detrimental outcomes and longer in-patient hospitalizations when drainage systems are employed 3, 6, 7, 10, 12, 15, 20, 25, 27, 31, 32. Despite this, closed-suction drainage is routinely used after shoulder arthroplasty 9, 17, 19. The only previously published study of drain use in shoulder arthroplasty was a prospective comparison of 300 open shoulder operations in 1997 by Gartsman et al 9 .…”

“…Interestingly, such an intense level of research has not been applied to patients undergoing shoulder arthroplasty. Given routine use of drains in many of these patients,9, 17, 19 research regarding the impact of drain use is warranted.…”

3D printed patient specific customised surgical jig for reverse shoulder arthroplasty, a cost effective and accurate solution

“…In view of the smaller size of the Asian glenoid[1], as well as the exposure of the glenoid face, much estimation and guesswork is required when placing the central wire that guides instrumentation. The placement of the central wire is key to achieving optimal bony purchase and therefore impacts implant stability and longevity [2]. Achieving a central position is difficult as the scapula converges to become a thin column of bone, and the intraoperative view glenoid does not reliably indicate the direction of this column of bone due to variation in the version of the scapula.…”

Artroplastia reversa de ombro: Resultados funcionais na artropatia do manguito

“…11 No entanto, os cirurgiões precisam estar cientes não só dos potenciais benefícios, mas também das complicações e preocupações em curso sobre a longevidade desta prótese. 12 O objetivo do nosso trabalho é avaliar os resultados funcionais e de melhora na qualidade de vida nos pacientes submetidos a artroplastia reversa após um seguimento de médio prazo, relatando as complicações por nós encontradas.…”