Complications of total shoulder arthroplasty: Are they fewer or different?

Chin, Patrick Y. K.; Sperling, John W.; Cofield, Robert H.; Schleck, Cathy D.

doi:10.1016/j.jse.2005.05.005

Cited by 246 publications

(123 citation statements)

References 2 publications

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“…Often, glenoid component loosening is not isolated, but combined with a rotator cuff tear, glenohumeral instability or component malposition [20]. Glenoid revision is indicated for painful glenoid loosening or glenoid malposition or wear in instances where the rotator cuff remains competent.…”

Section: Metal-backed Glenoid Component In a Platform System For Shoumentioning

confidence: 99%

Platform systems in shoulder arthroplasty

Werner

Dines

2016

Curr Rev Musculoskelet Med

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A platform system for shoulder arthroplasty can include a convertible modular humeral stem and/or a metal-backed glenoid component to facilitate straightforward conversion from either a hemiarthroplasty or anatomic total shoulder arthroplasty to a subsequent anatomic total shoulder arthroplasty, or more frequently, reverse total shoulder arthroplasty without any revision to the stem and/or glenoid baseplate. Recent studies have demonstrated a decreased rate of intraoperative humeral fracture, complications, and blood loss when a platform system is used and the humeral stem is not exchanged during revision arthroplasty. Future studies with larger patient cohorts are necessary to truly evaluate the potential value and limitations of this technology.

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Section: Metal-backed Glenoid Component In a Platform System For Shoumentioning

confidence: 99%

Platform systems in shoulder arthroplasty

Werner

Dines

2016

Curr Rev Musculoskelet Med

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“…Periprosthetic fractures associated with anatomic shoulder arthroplasty are relatively uncommon, with an incidence between 0.6% and 3% [1,6,8,9,12,15,18,19,[24][25][26].…”

Section: Introductionmentioning

confidence: 99%

What Are Risk Factors for Intraoperative Humerus Fractures During Revision Reverse Shoulder Arthroplasty and Do They Influence Outcomes?

Wagner

Houdek

Elhassan

et al. 2015

Clin Orthop Relat Res

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Background With the increase in shoulder arthroplasty rates, the number of perioperative complications, such as periprosthetic fractures, continues to be a rise; however, the risk factors and incidence of intraoperative complications, such as fractures, during revision reverse shoulder arthroplasty are not well established. Questions/purposes We evaluated patients receiving a reverse shoulder arthroplasty to determine (1) the frequency and characteristics of intraoperative humerus fractures, (2) the risk factors for fracture, (3) the complications associated with treatment of fractures, and (4) clinical and functional outcomes after treatment. Methods Using one institution's total joint registry, we performed a retrospective analysis of medical records of 224 patients (230 shoulders) who underwent revision surgery to reverse shoulder arthroplasty, from 2005 to 2012, for failed total shoulder arthroplasty. Reverse shoulder arthroplasty was used when there was a deficient rotator cuff, prior instability, or deficient glenoid bone stock. Intraoperative periprosthetic humerus fractures occurred in 36 shoulders (16%) (36 patients). The clinical outcome analysis included 29 patients with a minimum 2-year clinical followup (mean followup, 3.1 years; range, 2.0À6.3 years). The control group consisted of 188 patients (194 shoulders), and it was used for risk-factor calculation; whereas only 150 patients (154 shoulders) in the control group had a minimum 2-year followup, and thus only 150 patients (154 shoulders) made up the comparators (controls) for outcome-analysis comparisons. Risk factors were assessed using univariate analysis with odds ratios (OR), whereas implant survival and complications were assessed using the Kaplan-Meier method. Results Three displaced and 33 nondisplaced fractures occurred during revision reverse total shoulder arthroplasties. Most of the fractures (81%) occurred during component removal of cemented (n = 11) and cementless (n = 25) components. Intraoperative fractures only were treated with stabilization of the prosthetic stem in 28 patients, while adjunctive internal fixation was used in eight patients. Risk of intraoperative periprosthetic fractures was increased by factors including female sex (n =18 women; OR, 2.41; range, 1.11À5.68; p = 0.03); history of instability (n = 27; OR, 2.65; range, 1.18À5.93; p = 0.02); and prior hemiarthroplasty (n = 22; OR, 2.34; range, 1.13À4.84; p = 0.03). There were two postoperative fractures in patients who had an intraoperative fracture and both were treated nonoperatively. Overall, three (8%) revision procedures were performed in patients with intraoperative fractures, with 2-and 5-year survivorship estimates of 94% and 85%, respectively, compared with 89% and 84%, respectively for patients without an intraoperative fracture (p = 0.45). At latest followup, patients

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“…Although TSAs and reverse TSAs are done safely in most patients, some patients have medical or surgical complications develop that can lead to poor functional results and unanticipated hospital costs [3,5,47,53]. Although wide ranges have been reported for the frequency of complications with TSAs and reverse TSAs, the latter generally have complication rates that are higher, and sometimes several times higher, than the former [1,3,5,6,51,52,54,56].…”

Section: Introductionmentioning

confidence: 99%