“…1 ). Of the included studies, 9 were considered level of evidence III, 2 , 3 , 7 , 10 , 15 , 26 , 27 , 29 , 34 with the remaining 7 being level of evidence IV. 8 , 9 , 14 , 21 , 37 , 40 , 42 Figure 1 Flow diagram displaying the systematic review of search strategy.…”
Section: Resultsmentioning
confidence: 99%
“…Of the included studies, 5 studies utilized an anatomic implant, 2 , 3 , 7 , 26 , 29 4 studies utilized an rTSA implant, 8 , 9 , 15 , 37 4 studies utilized either a HA or an anatomic TSA implant, 14 , 21 , 27 , 40 2 utilized either a rTSA or an anatomic TSA implant, 10 , 34 and 1 study utilized all 3 implant types (TSA, rTSA, and HA). 42 Twelve studies specifically commented on their surgical approach, with 9 using a deltopectoral approach.…”
Section: Resultsmentioning
confidence: 99%
“…Previous multiple closed reduction Chronic locked dislocations or dislocations 79.2 mo § 80% had prior surgery 7 had Latarjet or Bristow rest had capsular surgery remaining 20% had closed reduction in history rTSA improved objective and subjective scores in patients with prior instability. 10 Reverse shoulder arthroplasty in the treatment of glenohumeral instability 15 3 33 (14:19) 11 rTSA ∗ vs. 22 rTSA † Control Study: 70 § Retrospective case series Recurrent instability after failed operation or associated with major bone loss –another stabilization procedure was not considered an option, traumatic dislocation - Study: (22-171) mo Control: 23-172 mo Study: 3 shoulder had prior surgeries (2 Bankart, 2 Latarjets) Control: 7 had RCR or débridement before index surgical procedure Pain score, SSV after rTSA improves outcomes for case group (recurrent instability) and has similar outcomes when compared to rTSA for cuff deficiency. 11 Shoulder arthroplasty after prior anterior stabilization procedures: do reverses have better outcomes?…”
“…1 ). Of the included studies, 9 were considered level of evidence III, 2 , 3 , 7 , 10 , 15 , 26 , 27 , 29 , 34 with the remaining 7 being level of evidence IV. 8 , 9 , 14 , 21 , 37 , 40 , 42 Figure 1 Flow diagram displaying the systematic review of search strategy.…”
Section: Resultsmentioning
confidence: 99%
“…Of the included studies, 5 studies utilized an anatomic implant, 2 , 3 , 7 , 26 , 29 4 studies utilized an rTSA implant, 8 , 9 , 15 , 37 4 studies utilized either a HA or an anatomic TSA implant, 14 , 21 , 27 , 40 2 utilized either a rTSA or an anatomic TSA implant, 10 , 34 and 1 study utilized all 3 implant types (TSA, rTSA, and HA). 42 Twelve studies specifically commented on their surgical approach, with 9 using a deltopectoral approach.…”
Section: Resultsmentioning
confidence: 99%
“…Previous multiple closed reduction Chronic locked dislocations or dislocations 79.2 mo § 80% had prior surgery 7 had Latarjet or Bristow rest had capsular surgery remaining 20% had closed reduction in history rTSA improved objective and subjective scores in patients with prior instability. 10 Reverse shoulder arthroplasty in the treatment of glenohumeral instability 15 3 33 (14:19) 11 rTSA ∗ vs. 22 rTSA † Control Study: 70 § Retrospective case series Recurrent instability after failed operation or associated with major bone loss –another stabilization procedure was not considered an option, traumatic dislocation - Study: (22-171) mo Control: 23-172 mo Study: 3 shoulder had prior surgeries (2 Bankart, 2 Latarjets) Control: 7 had RCR or débridement before index surgical procedure Pain score, SSV after rTSA improves outcomes for case group (recurrent instability) and has similar outcomes when compared to rTSA for cuff deficiency. 11 Shoulder arthroplasty after prior anterior stabilization procedures: do reverses have better outcomes?…”
“…Although reverse prostheses are used in growing numbers, they are accompanied by high rates of complications of up to 60% [2,3,11]. Besides infections, periprosthetic fractures, and loosening, a common cause of failure of reverse prostheses is instability [5,13,15]. Soft tissue balancing is known to play a major role in shoulder replacement, especially for stability.…”
Section: Influence Of Glenosphere Diameter and Lateralization On Instmentioning
confidence: 99%
“…Soft tissue balancing is known to play a major role in shoulder replacement, especially for stability. Furthermore, bone loss is common in many indications for reverse prostheses and is a known contributor to instability [13,15]. As RSA does not replicate normal joint anatomy, implant selection is a key factor in gaining joint stability by tensioning the deltoid muscle and the remaining soft tissues.…”
Section: Influence Of Glenosphere Diameter and Lateralization On Instmentioning
Background
Prosthetic replacement of the proximal humerus with reverse shoulder arthroplasty (RSA) is an established means of treatment. Due to its unique biomechanical characteristics, RSA can restore shoulder function to a satisfying level in the case of cuff tear arthropathy, arthritis, and fractures. However, complications are frequent in RSA, one of the more common being implant instability with dislocation. The present study investigated the influence of glenosphere diameter and metaglene lateralization using a unique test setup.
Methods
Seven fresh-frozen cadaveric specimens of the shoulder were thawed and dissected. The subscapularis muscle, the infraspinatus, and the three heads of the deltoid muscle were fixed to a pulley system. After implanting an RSA in different configurations (38/42 mm glenosphere with lateralization of +0 mm, +5 mm, or +10 mm), the implants were dislocated using selective muscle pull. The frequency of dislocations depending on the prosthesis configuration was documented.
Results
The larger glenosphere diameter of 42 mm showed less dislocations than the diameter of 38 mm (39 vs. 46). Lateralization of +0, +5 mm, and +10 mm showed 26, 29, and 30, dislocations, respectively. Dislocation via pull on the infraspinatus muscle was most frequent. None of the results reached statistical significance.
Conclusion
The current investigation used a novel technique for investigating the effect of lateralization and glenosphere diameter on RSA instability. Despite indicating tendencies, the present test setup could not prove the hypothesis that a larger glenosphere diameter and increased lateralization add to stability. The lack of statistical significance could be attributable to the low specimen number. The clinical significance of lateralization and glenosphere diameter should be further assessed in future biomechanical investigations.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
