Six-Year Experience with the Delta III Reverse Shoulder Prosthesis

Grassi, Federico Alberto; Murena, Luigi; Valli, Federico; Alberio, Riccardo Luigi

doi:10.1177/230949900901700205

Cited by 71 publications

(43 citation statements)

References 24 publications

(36 reference statements)

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“…All studies that reported this outcome measure showed a remarkably consistent improvement at a mean of 41.62 (range 39 to 46) points. This is comparable with studies looking at RSA in cuff tears (mean improvement of 43) [19,41,42] or cuff arthropathy (mean improvement of 41.33) [43][44][45] and suggests that outcome from RSA in RA is predictable.…”

Section: Discussionsupporting

confidence: 70%

“…Erosion of the glenoid makes implanting a component more challenging, predisposing to less satisfactory fixation, instability and early implant failure. Previous authors advocated hemi-arthroplasty as the treatment of choice in patients with large glenoid defects, bypassing issues of replacing the eroded socket [19][20][21]. However functional results were poor and deteriorated with time after the procedure, predominantly due to progressive glenoid wear [21][22][23].…”

Section: Introductionmentioning

confidence: 99%

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Reverse Shoulder Arthroplasty in Rheumatoid Arthritis: A Systematic Review

Gee¹,

Hanson²,

Saithna³

et al. 2015

Open Orthopaedics J

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Abstract:Background: Anatomical shoulder replacement for rheumatoid arthritis (RA) is complicated by a high incidence of rotator cuff tears and glenoid erosion. This can lead to poor function and early failure. Reverse shoulder arthroplasty (RSA) has gained popularity as an alternative. This systematic review attempts to further define the role of RSA in RA.Methods: A systematic review identified seven studies reporting outcomes of RSA in RA patients. Studies were critically appraised, and data on outcomes, complications and technical considerations were extracted and analysed.Results: One hundred and twenty one shoulders were included (mean follow up 46.9 months). Consistent improvements in the main outcome measures were noted between studies. Ninety five percent of patients described excellent to satisfactory outcomes. The minimum mean forward elevation reported in each study was 115 degrees. Symptomatic glenoid loosening (1.7%), deep infection (3.3%) and revision surgery (5%) rates were no higher than for a population of mixed aetiologies.Discussion: Previous concerns regarding high pre-and peri-operative complication and revision rates in RA patients were not shown to be valid by the results of this review. Although associated cuff tears are common and glenoid bone loss can increase the technical complexity of surgery, RSA provides consistent and predictable improvements in key outcome measures and the revision and complication rates do not appear to be higher than reported in a large population of mixed aetiologies. Conclusion:The contemporary literature shows that RSA is a safe, effective and reliable treatment option in RA patients.

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Section: Discussionsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Reverse Shoulder Arthroplasty in Rheumatoid Arthritis: A Systematic Review

Gee¹,

Hanson²,

Saithna³

et al. 2015

Open Orthopaedics J

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“…The major indication for using RTSA is arthritis associated with massive rotator cuff tears which accounts for approximately 90 % of the cases in different series [2,5,6,8,9,22]. The patient's age is important for the indication, as the implant longevity is not well understood; therefore, most authors do not advocate use of this type of implant for patients under 65 years of age [1,5,9,[23][24][25][26]. The use of reverse arthroplasty changes the Fig.…”

Section: Indicationsmentioning

confidence: 99%

Complications with reverse total shoulder arthroplasty and recent evolutions

Scarlat¹

2013

International Orthopaedics (SICOT)

119

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Since its description by Paul Grammont from Dijon, France, several tens of thousands of reverse total shoulder arthroplasties (RTSA) have been performed for diverse conditions. The purpose of this analysis is to identify the complications of this procedure in the literature and in clinical practice. A total of 240 papers concerning RTSA published between 1996 and 2012 have been identified. Over 80 papers describe complications associated with this type of implant. A list of prostheses satisfying European and US standards, CE and FDA approved, has been produced on the basis of information provided by the manufacturers. Data from the literature do not support a meta-analysis. The inventory of best practices shows excellent results in the short and medium term in specific indications, while the number of complications varies between 10 and 65 % in long-term series. Complications can be classified into (A) non-specific including infections (superficial and deep), phlebitis, haematoma, neurological complications of the suprascapular, radial and axillary nerves and (B) specific complications associated with RTSA including (1) on the glenoid side: intraoperative fracture of the glenoid and acromion, late fracture of the scapula, impingement at the scapular neck (notching), glenoid loosening, dissociation of the glenoid component (snatching of the glenosphere) and fractures of the glenoid baseplate; (2) on the humeral side: metaphyseal deterioration, humeral loosening, instability of the shoulder, stiffness with limitation of external and/or internal rotation; and (3) muscular complications with fatty degeneration of the deltoid. Additionally we have identified specific situations related to the type of implant such as the disassembly of the humeral or the glenoid component, dissociation of the polyethylene humeral plate, dissociation of the metaphysis and osteolysis of the tuberosities. The integration of results from different clinical series is difficult because of the lack of a database and the multitude of implants used.

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“…25 Now, indications are expanding, with many patients undergoing RSA for various pathologies such as failed total shoulder arthroplasty or hemiarthroplasty, complex proximal humeral fractures and fracture malunion or nonunion, rheumatoid arthritis with rotator cuff lesions, and failed or irreparable massive rotator cuff tears. [2][3][4][6][7][8][9]12,13,[15][16][17][18][19][20][21][22]24,28,29,31 Reported complications after RSA are worrisome and common. They can range from mechanical failures of the prosthesis, infection, and instability to intraoperative fractures.…”

mentioning

confidence: 99%

“…It has been described in all followup studies of RSA, with rates as high as 9%, accounting for almost half of the complications in some series. 1,[4][5][6][7][8]10,11,15,16,18,[26][27][28][29]30,31 Methods to reduce the incidence of dislocation after RSA are currently being examined. In this study, we investigated the effect of subscapularis repair on any report or findings of complications, including subset analyses of dislocation, infection, disassociation, and fracture after RSA with the Reverse Shoulder Prosthesis (RSP, DonJoy Surgical, Austin, TX, USA).…”

mentioning

confidence: 99%