Risk of insufficient internal rotation after bilateral reverse shoulder arthroplasty: clinical and patient-reported outcome in 57 patients

Wirth, Barbara; Kolling, Christoph; Schwyzer, Hans‐Kaspar; Flury, Manuel; Audigé, Laurent

doi:10.1016/j.jse.2015.11.010

Cited by 32 publications

(43 citation statements)

References 39 publications

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“…Stevens et al retrospectively reviewed the outcomes of 15 consecutive patents who underwent staged bilateral RSA for CTA and found that all patients were able to adequately perform ADLs that require IR including maintaining perineal hygiene 13). Wirth et al14) reported the results of 57 staged bilateral RSAs at least 1 year from their second arthroplasty surgery and found that at 1 year postoperatively 21% of patients had insufficient IR after their first surgery and 33% had insufficient IR after their second surgery. However, at 2 years postoperatively, only 5% of patients lacked sufficient IR bilaterally.…”

Section: Discussionmentioning

confidence: 99%

“…Historically, one concern of bilateral RSAs has been the impact on the performance of activities of daily living (ADLs), especially maintenance of perineal hygiene. However, recent evidence suggests that patients with bilateral RSAs are able to adequately perform these activities 11121314). Several other studies have reported the results of bilateral TSAs and RSAs independently 1516171819).…”

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confidence: 99%

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Outcomes of Bilateral Shoulder Arthroplasties: A Comparison of Bilateral Total Shoulder Arthroplasties and Bilateral Reverse Shoulder Arthroplasties

et al. 2019

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Background The purpose of this study was to compare outcomes of patients who underwent bilateral total shoulder arthroplasties (TSAs) for osteoarthritis (OA) versus bilateral reverse shoulder arthroplasties (RSAs) for cuff tear arthropathy (CTA). Methods Inclusion criteria were patients who underwent bilateral TSAs for OA or bilateral RSAs for CTA with at least 2 years of follow-up. Twenty-six TSA patients (52 shoulders) were matched 2 to 1 with 13 RSA patients (26 shoulders) by sex, age at first surgery, and time between surgeries. Outcomes measured were shoulder range of motion (ROM), complications, and patient-reported scores. Results Preoperatively, TSA patients had significantly better forward elevation (FE) of both shoulders than RSA patients (dominant side [Dom]: 103° ± 32° vs. 81° ± 31°, p = 0.047; nondominant side [non-Dom]: 111° ± 28° vs. 70° ± 42°, p = 0.005) without significant differences in external (ER) or internal rotation (IR). Postoperatively, TSA patients had significantly better FE (Dom and non-Dom: 156° ± 12°, 156° ± 14° vs. 134° ± 24°, 137° ± 23°; p = 0.006, p = 0.019) and ER (42° ± 11°, 43° ± 10° vs. 24° ± 12°, 25° ± 10°; p < 0.001, p < 0.001) bilaterally and IR of their dominant arm (L1 vs. L4, p = 0.045). TSA patients had significantly better activities of daily living external and internal rotations (ADLEIR) scores (Dom and non-Dom: 35.3 ± 1.0, 35.5 ± 0.9 vs. 32.1 ± 2.4, 32.5 ± 2.2; p = 0.001, p = 0.001), American Shoulder and Elbow Surgeons scores (94.2 ± 8.4, 94.2 ± 8.2 vs. 84.7 ± 10.0, 84.5 ± 8.0; p = 0.015, p = 0.004), and Single Assessment Numerical Evaluation (SANE) scores (93.5 ± 7.6, 93.8 ± 11.8 vs. 80.5 ± 14.2, 82.3 ± 13.1; p = 0.014, p = 0.025), with no significant difference in visual analog scale pain scores (0.4 ± 1.0, 0.3 ± 1.0 vs. 0.7 ± 1.3, 0.8 ± 1.2) bilaterally. Conclusions Overall, patients with bilateral TSAs and RSAs exhibited improved ROM and patient-reported outcomes. Those with bilateral TSAs had better functional outcomes than those with bilateral RSAs.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Outcomes of Bilateral Shoulder Arthroplasties: A Comparison of Bilateral Total Shoulder Arthroplasties and Bilateral Reverse Shoulder Arthroplasties

et al. 2019

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“…More recently, several studies have focused on patients treated with BSA, reporting mostly favorable outcomes. [18][19][20][21][22][23][24][25][26] However, functional outcomes, motion, and patient satisfaction among different combinations of BSA have not been comparatively reported in the literature. Results of this study show that despite superior pre-and postoperative outcomes in the setting of TSA/TSA, the effectiveness of treatment (pre-to postoperative) is comparable between any combination of TSA and RSA in the setting of BSA.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, it is important to better understand the impact of different combinations of shoulder arthroplasty as patients are more commonly being treated with RSA when other pathology within the shoulder make TSA less predictable. 17 Several studies have investigated bilateral TSA (TSA/ TSA), [18][19][20] bilateral RSA (RSA/RSA), [21][22][23][24][25] and unilateral TSA with contralateral RSA (TSA/RSA) 26 in isolation. However, no study to date has compared the outcomes among the different combinations of shoulder arthroplasties.…”

Section: Introductionmentioning

confidence: 99%

Comparative Outcomes of Various Combinations of Bilateral Shoulder Arthroplasty

Kurowicki

Triplet

Rosas

et al. 2019

Hand (New York, N,Y.)

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Background: In the setting of bilateral shoulder arthroplasty (BSA), differences in functional outcomes and motion between anatomic total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA) are unknown. The purpose of this study was to compare the effectiveness of treatment for various combinations of TSA procedures. Methods: A review of prospectively collected data from an institutional shoulder surgery repository was performed for patients who underwent any combination of bilateral TSA or RSA surgery. Based on the combination of shoulder arthroplasty, patients were divided into the following subgroups: bilateral TSA (TSA/TSA), bilateral RSA (RSA/RSA), or unilateral TSA with contralateral RSA (TSA/RSA). A total of 73 patients (146 shoulders), with a minimum of 2-year follow-up, who underwent any combination of bilateral TSA or RSA from 2007 to 2014 were included. Pre- and postoperative patient-reported outcome measures and measured motion were evaluated between the 3 groups. Results: There were 47 TSA/TSA, 17 RSA/RSA, and 9 TSA/RSA patients with a mean age of 72 years and mean follow-up of 51 months. Preoperatively, TSA/TSA had significantly higher Simple Shoulder Test scores, Visual Analog Scale (VAS) function, active elevation, and active external rotation compared with RSA/RSA. Postoperative scores were significantly superior in TSA/TSA compared with other combinations of shoulder arthroplasty except VAS pain and function. Change in pre- to postoperative (effectiveness of treatment) internal rotation was superior in the TSA/TSA group compared with RSA/RSA and TSA/RSA; however, no other differences were observed. Conclusions: Bilateral TSA patients have higher preoperative function and motion. Although some postoperative outcomes differ among combinations of BSA, the overall effectiveness of treatment for patients undergoing BSA is similar between various combinations of arthroplasty.

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“…IR is of particular interest as a ROM outcome in the context of evaluating the comparative outcomes of anatomic vs. reverse TSA, as poorer IR outcomes have been shown in some large-scale analyses of reverse TSA relative to anatomic TSA. 3 , 19 IR and other ROM have an effect on patient-reported outcomes. Worsening ROM is reflected in worse overall outcome scores as well as patient impairment with ADLs.…”

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confidence: 98%

Shoulder motion decreases as body mass increases in patients with asymptomatic shoulders

Allen¹,

Lin²,

Barfield³

et al. 2020

JSES International

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Background Higher complication rates are reported after shoulder arthroplasty in obese patients. Understanding the effect of body mass index (BMI) on range of motion (ROM) in asymptomatic shoulders may be useful in evaluating clinical outcomes for patients of varying BMIs presenting with shoulder pathology. The purpose of this study is to investigate patient characteristics, in particular BMI, that may affect ROM outcomes after shoulder arthroplasty. Methods Individuals aged 18 years or older (mean 57.21 ± 16.27 years) were recruited with asymptomatic shoulder presentation and without history of shoulder injury. A total of 224 shoulders were grouped into 4 BMI categories, and ROM was measured with a goniometer. Analysis was performed between patient demographics and ROM. Results Analyzed continuously, BMI negatively correlated with ROM for internal rotation (IR; r = −0.511, P < .01), forward elevation (FE; r = −0.418, P < .01), and external rotation (ER; r = −0.328, P < .01). ROM analyzed by BMI category revealed a dose effect of BMI vs ROM. Obese patients demonstrated a significant decrease in IR whereas morbidly obese patients had significant decreases for all ranges: IR ( r = −0.469, P < .01), FE ( r = −0.452, P < .01), and ER ( r = –0.33, P < .01). Normal- and overweight patients revealed no significant correlations with ROM. Conclusion As BMI is negatively correlated with ROM of the asymptomatic shoulder, patients with higher BMIs may be predisposed to diminished outcomes postoperatively. These baseline correlations will allow surgeons to make postoperative expectations and anticipate poorer outcomes of shoulder ROM in obese patients.

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Risk of insufficient internal rotation after bilateral reverse shoulder arthroplasty: clinical and patient-reported outcome in 57 patients

Cited by 32 publications

References 39 publications

Outcomes of Bilateral Shoulder Arthroplasties: A Comparison of Bilateral Total Shoulder Arthroplasties and Bilateral Reverse Shoulder Arthroplasties

Outcomes of Bilateral Shoulder Arthroplasties: A Comparison of Bilateral Total Shoulder Arthroplasties and Bilateral Reverse Shoulder Arthroplasties

Comparative Outcomes of Various Combinations of Bilateral Shoulder Arthroplasty

Shoulder motion decreases as body mass increases in patients with asymptomatic shoulders

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