Reverse Total Shoulder Arthroplasty

Guéry, J; Favard, Luc; Sirveaux, François; Oudet, Didier; Molé, Daniel; Walch, Gilles

doi:10.2106/jbjs.e.00851

Cited by 557 publications

(174 citation statements)

References 19 publications

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“…Woodruff et al [25] reported on 13 shoulders with a postoperative score of 59 after a mean followup of 87 months. However, our scores are slightly inferior to some that have been reported in patients with cuff tear arthropathy with Constant-Murley scores of up to 60 to 65 (Table 2) [4,7,11,18,20,[22][23][24].…”

Section: Figcontrasting

confidence: 81%

“…However, the mean followup was only 56 months and further studies are needed to determine long-term survival of the implant in this patient group. Age must therefore be taken into consideration when considering a reverse arthroplasty [11]. If an elderly patient with rheumatoid arthritis has pain and poor active ROM (pseudoparalysis) as a result of arthritic changes and a massive cuff tear, a reverse arthroplasty should be considered.…”

Section: Figmentioning

confidence: 99%

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Can Reverse Shoulder Arthroplasty be Used with Few Complications in Rheumatoid Arthritis?

Ekelund

Nyberg

2011

Clinical Orthopaedics &Amp; Related Research

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Background Many patients with rheumatoid arthritis develop superior migration of the humeral head because of massive cuff tears, causing loss of active motion. Reverse shoulder arthroplasty could potentially restore biomechanical balance but a high incidence of glenoid failure has been reported. These studies do not, however, typically include many patients with rheumatoid arthritis (RA) and it is unclear whether the failure rates are similar. Questions/purposes We therefore (1) evaluated pain relief and shoulder function after reverse arthroplasty in RA; (2) compared results between primary and revision procedures; (3) determined the incidence of scapular notching; and (4) determined the complication rate. Methods We identified 29 patients with RA who had 33 reverse arthroplasties from among 412 patients having the surgery. Six patients were lost to followup. Twenty three patients (27 shoulders) were evaluated after a minimum followup of 18 months (mean, 56 months; range, 18-143 months), including 18 primary and nine revision arthroplasties. All patients were evaluated preoperatively and 23 shoulders postoperatively by an independent physiotherapist and four were assessed postoperatively by phone. Level of pain, range of motion, and ConstantMurley score were recorded and new radiographs taken.

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Section: Figcontrasting

confidence: 81%

Section: Figmentioning

confidence: 99%

Can Reverse Shoulder Arthroplasty be Used with Few Complications in Rheumatoid Arthritis?

Ekelund

Nyberg

2011

Clinical Orthopaedics &Amp; Related Research

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“…Improvement of over 40% for both the relative Constant Score and SSV after a mean follow-up of 93 months is consistent with other studies of RTSA in older patients. 18 Favard et al (2011) postulated that this may reflect the delayed consequences of radiographic signs of potential failure, however this has not been confirmed. 9 In our study, we found no significant change in both the functional scores and SSV over a 10-year period.…”

Section: Discussionmentioning

confidence: 99%

Reverse total shoulder arthroplasty for massive irreparable rotator cuff tears in patients younger than 65 years old: results after five to fifteen years

Neukom

Catanzaro

et al. 2013

Journal of Shoulder and Elbow Surgery

343

193

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Reverse total shoulder arthroplasty for massive irreparable rotator cuff tears in patients younger than 65 years old: results after five to fifteen years Ek, Eugene T H; Neukom, Lisa; Catanzaro, Sabrina; Gerber, Christian Abstract: BACKGROUND: The role of reverse shoulder arthroplasty (RTSA) in the relatively young individual is currently unclear. Our study evaluates the midterm to long-term results of RTSA for patients aged younger than 65 years with pseudoparalysis secondary to massive irreparable rotator cuff tears, with or without arthritis. METHODS: Between 1997 and 2006, 46 RTSAs (41 patients) were performed. Mean age was 60 years (range, 46-64 years). At the latest follow-up, 5 patients had died and 1 was lost, leaving 35 patients (40 shoulders) with a mean follow-up of 93 months (range, 60-171 months). RESULTS: The mean relative Constant score increased from 34% to 74% (P < .0001) and the subjective shoulder value improved from 23% to 66% (P < .0001). Significant improvements were seen in active forward elevation (72°to 119°), pain scores, and strength (P < .001). One or more complications occurred in 15 shoulders (37.5%), with 6 failures (15%) resulting in removal or conversion to hemiarthroplasty (3 with infection, 3 with glenoid loosening). Ten shoulders (25%) underwent partial or total component exchange, conversion to hemiarthroplasty, or removal. Of the 15 patients who developed complications, 9 did not require prosthesis removal or conversion and functional outcome and subjective shoulder value were similar to those with no complications (P > .4). CONCLUSION: RTSA in younger patients provides significant subjective improvement and substantial gain in overall function, which is maintained up to 10 years. Although the complication rate is high, most can be treated successfully without compromise to clinical outcome. However, it is imperative that the high complication rate is explained to patients, with the risks and benefits carefully considered. Conflict of interest/Disclaimer: Christian Gerber receives royalties from Zimmer Inc, which is related to the subject of this article. All other authors, their immediate family, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.Reverse shoulder arthroplasty in younger patients 2 ABSTRACT Background:The role of reverse shoulder arthroplasty (RTSA) in the relatively young individual is currently unclear. Our study evaluates the mid to long-term results of RTSA for patients less than 65 years with pseudoparalysis secondary to massive irreparable rotator cuff tears with or without arthritis. Methods:Between 1997 and 2006, 46 RTSAs (41 patients) were performed. Mean age was 60 years (range, 46-64). At latest follow-up, 5 patients had died and 1 was lost, leaving 35 patients (40 shoulders) with a mean follow-up of 93 months (range, 60-171). Results:Mean relative Constant score increased from 34% to 74% (p<0.0001) and subjective s...

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“…This large database study does not have preoperative and postoperative patient outcome scores. However, the clinical improvement after RTSA and TSA has been widely documented 3,[18][19][20] and was not the aim of this study.…”

Section: Original Research and Contributionsmentioning

confidence: 99%

Effect of Age on Outcomes of Shoulder Arthroplasty

Anakwenze

Yehyawi

Dillon

et al. 2017

TPJ

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Context: Outcomes of total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA) as a function of age are not well known.Objective: To understand the effects of age on revision rate, mortality, and hospital readmissions.Design: A retrospective cohort study of prospectively collected data. Using an integrated health care system's shoulder arthroplasty registry, we identified patients who underwent TSA and RTSA between January 2007 and June 2012. Patients were grouped into older (> 75 years) and younger groups (≤ 75 years).Main Outcome Measures: Differences in outcomes between both age groups.Results: The TSA cohort had 2007 patients, and 538 (26.8%) were older than age 75 years. Older patients who underwent TSA had higher risks of 1-year mortality (2.0% vs 0.6%; odds ratio = 3.34, 95% confidence interval [CI] = 1.00-11.11, p = 0.049) and readmission within 90 days (7.6% vs 4.4%; odds ratio = 1.75, 95% CI = 1.17-2.63, p = 0.007). The RTSA cohort had 568 patients, and 295 (51.9%) of them were older than age 75 years. Older RTSA patients had a lower risk of revision (3.7% vs 8.1%; hazard ratio = 0.45, 95% CI = 0.24-0.89, p = 0.020).Conclusion: Patient age is one of many important variables that surgeons should consider when performing shoulder arthroplasty. However, the impact of age in the TSA and RTSA populations is different. In the TSA cohort, older patients have higher risk of readmission and mortality. In the RTSA cohort, older patients have lower risk of revision.

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Reverse Total Shoulder Arthroplasty

Abstract: Our findings indicate that the reverse total prosthesis should be reserved for the treatment of very disabling shoulder arthropathy with a massive rotator cuff rupture, and it should be used exclusively in patients over seventy years old with low functional demands.

Cited by 557 publications

References 19 publications

Can Reverse Shoulder Arthroplasty be Used with Few Complications in Rheumatoid Arthritis?

Can Reverse Shoulder Arthroplasty be Used with Few Complications in Rheumatoid Arthritis?

Reverse total shoulder arthroplasty for massive irreparable rotator cuff tears in patients younger than 65 years old: results after five to fifteen years

Effect of Age on Outcomes of Shoulder Arthroplasty

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