Reverse total shoulder arthroplasty

Familiari, Filippo; Rojas, Jorge; Doral, Mahmut Nedim; Huri, Gazi; McFarland, Edward G.

doi:10.1302/2058-5241.3.170044

Cited by 90 publications

(50 citation statements)

References 125 publications

(155 reference statements)

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“…Irreparable posterosuperior rotator cuff ruptures in the young patient remain a challenging clinical entity. Owing to high revision rates reported in young patients ranging between 18 and 48%, reverse shoulder arthroplasty is considered the last-line treatment [6,8,17,23]. Thus, the general clinical goal is to delay arthroplasty for as long as possible.…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic superior capsular reconstruction using a human dermal allograft in patients with and without preoperative pseudoparalysis

et al. 2019

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Background Massive irreparable rotator cuff tears (RCT) may cause severe functional impairment and pain as a result of loss of superior humeral stability. Reconstruction of the superior capsule (SCR) has been reported to restore glenohumeral stability and function. Objective The purpose of this study was to investigate short-term functional and radiological outcome after arthroscopic SCR with a human dermal allograft for irreparable RCT. Methods In total, 21 patients (mean age 65.9 years, 50–77), who underwent arthroscopic SCR were prospectively enrolled in the present study. Magnetic resonance images (MRI) were obtained before and 12 months after surgery to evaluate graft survival. Functional and subjective outcome including the Constant score (CS), the American Shoulder and Elbow Surgeons score (ASES), and the Simple Shoulder Test (SST) was evaluated preoperatively as well as 3–6 and 12 months postoperatively and was compared between patients with and without preoperative pseudoparalysis. Complications were recorded. Results The MRI evaluation revealed intact grafts in 71.4% of patients 1 year postoperatively; these patients showed significant improvements from baseline to follow-up time points regarding the total CS and its subgroups pain, activity of living, range of motion, strength, ASES, and SST (p < 0.01). Pseudoparalysis was present in 57.1% of cases preoperatively, but was reversed in 100% of cases with intact graft at the 1‑year follow-up. The outcome was similar between groups at final follow-up. Complications occurred in 29% (one infection, five graft failures) of patients and were indications for treatment with reverse shoulder arthroplasty. Conclusion Arthroscopic SCR with a human dermal allograft in patients with irreparable RCT restored shoulder function and relieved pain in patients without and with preoperative pseudoparalysis.

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Section: Introductionmentioning

confidence: 99%

Arthroscopic superior capsular reconstruction using a human dermal allograft in patients with and without preoperative pseudoparalysis

et al. 2019

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“…Generally, the complication rate of reverse total shoulder arthroplasty is reported to be 19-68%. Therefore, reverse total shoulder arthroplasty is not an easy choice for treating proximal humeral fractures even in the elderly [2].…”

Section: Discussionmentioning

confidence: 99%

Results of surgery using a locking plate for proximal humerus fractures in patients older than 80 years: A retrospective case series

Shin

Kang

Son

et al. 2019

Preprint

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Background: To evaluate the results of surgical treatment using a locking plate for proximal humeral fractures in patients aged >80 years. Methods: Between September of 2013 and March of 2016, there were 22 patients who received locking plate fixation from proximal humeral fractures over 80 years-old. Among the 22 cases, Clinical, radiological results were analyzed for 19 patients who were able to follow up more than one year. We analyzed bone union, neck-shaft angle, UCLA score, range of motion compared to opposite side and complication. Clinical, radiological results were investigated for medial comminuted fracture or not.Results: All the patients achieved bone union. The mean bone union time was 13.7 weeks, and the mean neck-shaft angle was 126.4. The mean University of California, Los Angeles, shoulder score was 22.4, and score was <28 point in 12 patients. The mean forward flexion, abduction, external rotation, and internal rotation angles were 129.2°, 112.3°, 44.2°, and L2. All motions were significantly different from the normal shoulder motion. A significant difference was found in the loss of neck-shaft angle according to the medial comminuted fracture.Conclusion: In the surgical treatment of proximal humeral fractures in patients aged >80 years, use of a locking plate attained bone union with relatively satisfactory results. However, we considered that prevention of and training for postoperative stiffness are necessary. Other surgical methods should be considered for patients with complex displaced fractures, especially those with medial comminuted fractures.

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“…Scapular notching is a specific complication to RSA, with a reported incidence of 50 to 96% [39]. From a biomechanical point of view, scapular notching would reflect a mechanical impingement of the humeral cup on the lateral scapular pillar during adduction, related to medialization of the shoulder’s rotation center.…”

Section: Specific Complications Of Different Shoulder Prosthesesmentioning

confidence: 99%

Imaging of shoulder arthroplasties and their complications: a pictorial review

et al. 2019

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Currently, an increasing number of patients benefit from shoulder prosthesis implantation. Radiologists are therefore more often confronted with imaging examinations involving shoulder arthroplasty, whether during a dedicated examination or incidentally. Standard radiography is the first-line imaging modality in the follow-up of these implants, before the possible use of cross-sectional imaging modalities (computed tomography and magnetic resonance imaging), ultrasound, or nuclear medicine examinations. Shoulder arthroplasties are divided into three categories: reverse shoulder arthroplasty, total shoulder arthroplasty, and partial shoulder joint replacement (including humeral hemiarthroplasty and humeral head resurfacing arthroplasty). Each of these prostheses can present complications, either shared by all types of arthroplasty or specific to each. Infection, periprosthetic fractures, humeral component loosening, heterotopic ossification, implant failure, and nerve injury can affect all types of prostheses. Instability, scapular notching, and acromial fractures can be identified after reverse shoulder arthroplasty implantation. Glenoid component loosening and rotator cuff tear are specific complications of total shoulder arthroplasty. Progressive wear of the native glenoid is the only specific complication observed in partial shoulder joint replacement. Knowledge of different types of shoulder prostheses and their complications’ radiological signs is crucial for the radiologist to initiate prompt and adequate management.

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Reverse total shoulder arthroplasty

Cited by 90 publications

References 125 publications

Arthroscopic superior capsular reconstruction using a human dermal allograft in patients with and without preoperative pseudoparalysis

Arthroscopic superior capsular reconstruction using a human dermal allograft in patients with and without preoperative pseudoparalysis

Results of surgery using a locking plate for proximal humerus fractures in patients older than 80 years: A retrospective case series

Imaging of shoulder arthroplasties and their complications: a pictorial review

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