Reverse shoulder arthroplasty versus nonoperative treatment for 3- or 4-part proximal humeral fractures in elderly patients: a prospective randomized controlled trial

Lópiz, Yaiza; Alcobía-Díaz, B.; Galán-Olleros, María; García-Fernández, Carlos; Picado, Amanda López; Marco, Fernando

doi:10.1016/j.jse.2019.06.024

Cited by 110 publications

(88 citation statements)

References 59 publications

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“…Jason Ferrel [29] agreed that RSA signi cantly improved forward shoulder exion (range of motion greater than 10°) and had a relatively low revision rate (0.93%) compared to hemiarthroplasty. In this meta-analysis, according to the complications described in the literature [11,14,15,20], we found RSA compared to hemiarthroplasty had a lower incidence of complications after surgery, Clark, NJ. [30] clinical trials also proved the point, at the same time, they thought primary RSA was effective in the treatment of PHF, lower in medical and surgical complications, RSA was also effective in patients over 80 years of age after a comprehensive evaluation.…”

Section: Discussionmentioning

confidence: 80%

“…Therefore, we divided the study into two subgroups based on built-in differences. In the comparison between the plate group (conservation and surgery group), Chi 2 = 0.18, P = 0.67 > 0.05, there was no signi cant difference in the functional score of the PHFs (Figure 6) and the prosthesis group Z = 2.35, p = 0.02 < 0.05, with signi cant difference, which may be caused by the small sample size of this subgroup, and the use of Reverse Shoulder System implant by Matthieu Chivot [20] and Yaiza Lopiz [15], while the use of hemiarthroplasty by Per Olerud [11] and Harm w. Boons [14]. Although both were arthroplasty, there were still some differences in postoperative functional scores between the two surgical methods.…”

Section: Functional Outcomementioning

confidence: 88%

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Is Surgery Better Than Conservative Treatment for Proximal Humeral Fracture: A Systematic Review and Meta-Analysis

Gong¹,

Lin²,

Xu³

et al. 2020

Preprint

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Background: Previous studies had compared the effectiveness of surgical and conservative treatment in proximal humeral fracture (PHF), suggesting that both treatments were effective for displaced fractures. However, which treatment is more effective, especially in the elderly patient population, remains controversial to date. This study aims to evaluate the efficacy of the two treatment methods, including functional outcome scores, complications, etc.Methods: We searched four databases (MEDLINE, Web of Science, EMBASE, Cochrane Library) from the inception of the databases to March 2020. Within the scope of the search, the publication time and language of the relevant literatures were not limited. The meta-analysis directly compared the results and complications of the two groups and subgroups. Results: We included 11 comparative studies into our meta-analysis. The contents of the study included 7 randomized controlled trials (RCTs) and 4 non-randomized controlled trials (nRCTs). The pooled data demonstrated that there was no significant difference in postoperative Constant score between surgical and conservative treatment in the RCT subgroup, but there were differences among the nRCT and prosthesis subgroup. Although there was no significant difference between the surgery and conversation group in the major postoperative complications, the subgroup analysis showed fewer complications in the joint prosthesis replacement group. Conclusion: Both treatments could provide better clinical results for patients. The joint prosthesis replacement may offer additional benefits in terms of reduced complications and postoperative function. Furthermore, due to the increasing number of prosthesis replacements and the advent of the aging age, we should consider the individual differences between patients and enrich the clinical efficacy through the personal experience of surgeons before choosing treatment options.

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Section: Discussionmentioning

confidence: 80%

Section: Functional Outcomementioning

confidence: 88%

Is Surgery Better Than Conservative Treatment for Proximal Humeral Fracture: A Systematic Review and Meta-Analysis

Gong¹,

Lin²,

Xu³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Follow-up of patients was completed at 12 months following surgery. The visual analogue scale (VAS) score (7), elbow flexion strength (8), elbow joint supination muscle strength (9), the University of California Los Angeles (UCLA) shoulder score (10) and Rating Scale of American Shoulder Elbow Surgeons (ASES) score (11) were determined to evaluate the outcome of the surgery. These parameters were used to evaluate the discrepancies between pre-operation and post-operation.…”

Section: Methodsmentioning

confidence: 99%

Modified keyhole technique for the treatment of biceps long head tendon rupture

Huang

Shu

et al. 2019

Exp Ther Med

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The present study aimed to assess a novel modified keyhole fixation technique to treat long head of biceps (LHB) rupture. From May 2015 to July 2017, a total of 9 patients with LHB rupture, decreased muscle strength and pop-eye sign were treated using the keyhole fixation technique combined with extramedullary cortical bone microplate-suspending fixation. Measurements of visual analog scale (VAS) score, elbow joint rotation, flexion strength, the Shoulder Score of the University of California Los Angeles (UCLA) and the Rating Scale of American Shoulder Elbow Surgeons (ASES) score were used to evaluate surgical outcomes prior to and following surgery. The 9 patients with LHB rupture included in the study were followed up for one year post-surgery. The supination and flexion elbow strength of all patients after 1 year was grade V and shoulder pain was relieved. The VAS, UCLA shoulder and ASES scores at one year post-surgery were significantly improved compared with those prior to surgery. In conclusion, modified keyhole fixation for LHB rupture features low difficulty of operation, high safety and reliable fixation, and is therefore a promising novel technique for the treatment of LHB rupture.

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“…A randomized controlled trial yields important evidence for the treatment of complex proximal humeral fractures in elderly patients suggesting minimal benefits of reverse shoulder arthroplasty over nonoperative treatment for displaced three-and four-part proximal humeral fractures. [1] Whether arthroscopic partial meniscectomy for symptomatic patients with a meniscal tear and knee osteoarthritis results in better functional outcomes than nonoperative therapy is uncertain. In the intention-to-treat analysis, Katz et al [2] did not find any significant differences between the study groups in functional improvement six months after randomization; and only 30% of the patients who were assigned to physical therapy alone underwent surgery within six months.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

Elective surgeries during COVID-19 storm: The best surgeon knows when not to operate

Atik¹

2020

Jt Dis Relat Surg

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Reverse shoulder arthroplasty versus nonoperative treatment for 3- or 4-part proximal humeral fractures in elderly patients: a prospective randomized controlled trial

Cited by 110 publications

References 59 publications

Is Surgery Better Than Conservative Treatment for Proximal Humeral Fracture: A Systematic Review and Meta-Analysis

Is Surgery Better Than Conservative Treatment for Proximal Humeral Fracture: A Systematic Review and Meta-Analysis

Modified keyhole technique for the treatment of biceps long head tendon rupture

Elective surgeries during COVID-19 storm: The best surgeon knows when not to operate

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