Revision Reverse Shoulder Arthroplasty

Chalmers, Peter N.; Boileau, Pascal; Romeo, Anthony A.; Tashjian, Robert Z.

doi:10.5435/jaaos-d-17-00535

Cited by 83 publications

(50 citation statements)

References 39 publications

(65 reference statements)

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“…86,87 Postsurgical complications include instability, infection, fracture, and loosening, and the ability to discriminate between infection and aseptic loosening has important implications for patient management. [88][89][90][91] The first-line modality after hip or knee arthroplasty is radiography, which can show subsequent fractures and dislocations. Although the high sensitivity of 3-phase BS can be used to rule out postsurgical loosening and infection, 92 the addition of anatomic information in SPECT/CT can improve the otherwise low specificity.…”

Section: Orthopedic Complicationsmentioning

confidence: 99%

Novel Musculoskeletal and Orthopedic Applications of 18F-Sodium Fluoride PET

et al. 2021

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The bone-seeking properties of 18 F-sodium fluoride (NaF) were first described in 1962 by Blau and colleagues, 1 who used this positron-emitting radiotracer in skeletal scintigraphy. Both high uptake by bone and rapid plasma clearance of NaF were determined to be advantages in imaging skeletal metabolism. 2 The mechanism of NaF uptake relies on the exchange of OH À for 18 F À , converting hydroxyapatite on the surface of the bone matrix to fluorapatite. 2,3 One hour after NaF is administered intravenously, only 10% remains in the plasma compartment because of a first-pass Conflict of interest: The authors have declared no conflicts of interest.

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Section: Orthopedic Complicationsmentioning

confidence: 99%

Novel Musculoskeletal and Orthopedic Applications of 18F-Sodium Fluoride PET

et al. 2021

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“…Frequently, shoulder revision surgeries are due to humeral proximal bone defects, both as a consequence of infection and as a result of primary arthroplasty removal. In cases of massive metaphyseal humeral bone loss, several techniques have been described such as bone allografts or bone cement [ 34 , 35 , 36 ]. However, to date, there no studies in the literature that have reported the use of tantalum in humeral bone loss, whereas in hip/knee arthroplasty [ 37 , 38 , 39 , 40 , 41 , 42 ] or glenoid [ 43 , 44 , 45 ] revisions this has been extensively studied.…”

Section: Bone Loss Management—tantalum Conesmentioning

confidence: 99%

“…This technique demonstrated excellent 5- and 10-year survivorship in aseptic prosthetic revision [ 46 , 47 ]. A potential disadvantage may be represented by revision of well-fixed tantalum cones: explant can be very challenging with extended bone loss and the issue should be considered when using tantalum augments, but other treatment alternatives in humeral massive defects (tumoral prostheses, bone allografts or bone cement) are burdened by technical problems and major complications, as well [ 34 , 35 , 36 ].…”

Section: Bone Loss Management—tantalum Conesmentioning

confidence: 99%

An Evolution of Shoulder Periprosthetic Infections Management: MicroDTTect, Bioactive Glass and Tantalum Cones Employment

Romano

Ascione

Casillo³

et al. 2020

JCM

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Periprosthetic joint infections of the shoulder (PJIS) are the major cause for revision within the first two post-operative years, and are challenging both to diagnose and treat. Success depends on early identification of microorganisms, appropriate surgical procedures and efficient antibiotic administration. The peculiar microbiology of the shoulder may render the criteria for hip/knee PJI management inappropriate. In addition, later cases with clinically subtle signs often present diagnostic challenges. In recent years, specific issues of PJIS have been managed through the use of new instruments, such as MicroDTTect in pathogen detection and Bioactive Glass and tantalum cones in humeral bone loss. In the literature to date, no reports have been found that discuss the application in shoulder revisions and infections. The early identification of the microorganisms that cause infection may help improve both treatment strategies and the efficacy of therapy. MicroDTTect proved to be more efficient than swab collection for bacterial identification in orthopedic surgery, thus reducing analysis costs. The increasing number of shoulder arthroplasties is associated with an increase in the number of revisions. In cases of massive metaphyseal humeral bone loss, several techniques have been described; no reports have been reported regarding tantalum in humeral bone loss management. In some cases the tantalum cones required adaptation for femoral diaphysis in the augmentation of the humerus metaphysis and bone loss management improvement. Obtaining stable osseointegration of prosthetic implants is one of the greatest issues in orthopedic surgery, and even more crucial in revisions. Bioactive glasses demonstrated good regenerative and osseointegration properties, and an excellent candidate as a bone graft, scaffold and antibiotics deliverer. The Bioactive glasses were used to increase prosthesis-bone interface stability and fill bone defects in PJIS revision surgeries, contributing to the prevention of re-infection. Longer-term follow-up will be necessary to determine if construction durability is improved in the long term.

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“…Augments are customizable and may produce a lower complication rate than bone grafting with regard to scapular notching, disease transmission, and host incorporation. 26,27 However, they may be costly and may increase bone-implant forces. Ivaldo et al described another technique where a customized porous tantalum device is fixed to the metal back of the glenoid component for management of glenoid bone loss and medialization, with good patient satisfaction and return to daily activities.…”

Section: Glenoid Bone Lossmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Management of Revision Reverse Shoulder Arthroplasty

Goldman

Halpern

Deal

et al. 2020

Journal of Shoulder and Elbow Arthroplasty

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Background: The number of reverse total shoulder arthroplasty procedures performed has increased in recent years due to expanding surgical indications. There has been a proportional increase in complications, with reported complication rates for a revision reverse total shoulder arthroplasty as high as 68%. Revising a reverse total shoulder is a complex procedure requiring significant preoperative planning. Methods: A literature review of revision shoulder arthroplasty techniques was performed. No IRB approval was needed for this study. Results: Instability is the most common reason for revision reverse total shoulder arthroplasty followed by infection. Revision arthroplasty is also needed in the setting of bone loss, aseptic loosening, and periprosthetic fracture. Each case requires a comprehensive preoperative plan to address each deformity for a successful result. Conclusions: For this procedure to be successful, it is imperative that the physician understands the risk factors, identifies the cause, and is familiar with current surgical techniques. This study reviews both preoperative and perioperative management of reverse total shoulder arthroplasty in the revision setting.

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Revision Reverse Shoulder Arthroplasty

Cited by 83 publications

References 39 publications

Novel Musculoskeletal and Orthopedic Applications of 18F-Sodium Fluoride PET

Novel Musculoskeletal and Orthopedic Applications of 18F-Sodium Fluoride PET

An Evolution of Shoulder Periprosthetic Infections Management: MicroDTTect, Bioactive Glass and Tantalum Cones Employment

Management of Revision Reverse Shoulder Arthroplasty

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