Early outcomes of locked noncemented stems for the management of proximal humeral fractures: a comparative study

Jorge-Mora, Alberto; Amhaz-Escanlar, Samer; Fernandez-Pose, Sabela; Lope-del-Teso, Cristina; Pino, Jesús; Caeiro-Rey, José Ramón; Pretell-Mazzini, Juan; Gómez, Rodolfo

doi:10.1016/j.jse.2018.05.036

Cited by 21 publications

(12 citation statements)

References 37 publications

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“…For the design of prosthesis, five studies only used a fracture-dedicated prosthesis ( 19 , 20 , 35 , 36 , 40 ) and six studies used a standard prosthesis ( 4 , 16 , 34 , 37 , 39 , 42 ). One study both used a fracture-dedicated prosthesis and a standard prosthesis ( 41 ) and one study did not report the specific prosthesis used ( 38 ).…”

Section: Resultsmentioning

confidence: 99%

“…However, there was significant heterogeneity among the included studies ( I 2 = 77%, p < 0.00001). Seven studies reported shoulder abduction ( 16 , 19 , 20 , 34 , 36 , 41 , 42 ) and the overall result showed that the healed groups had better abduction than the non-healed groups (MD = 15.95, 95% CI = 2.49 to 29.41, p = 0.02) ( Table 3 ). However, high heterogeneity existed among the included studies ( I 2 = 79%, p < 0.0001).…”

Section: Resultsmentioning

confidence: 99%

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Fracture-Dedicated Prosthesis Promotes the Healing Rate of Greater Tuberosity in Reverse Shoulder Arthroplasty: A Meta-Analysis

Liao

Guo

et al. 2021

Front. Surg.

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Introduction: Reverse shoulder arthroplasty (RSA) is becoming popular in the treatment of complex proximal humeral fractures (PHFs). Greater tuberosity healing may influence functional outcomes and range of motion (ROM) of shoulder after RSA. In addition, the design of prosthesis may impact the healing rate of greater tuberosity. The purpose of this study is to know: (1) does the healing of greater tuberosity affect the functional outcomes and ROM of shoulder? and (2) does the design of prosthesis affect the healing rate of greater tuberosity?Materials and Methods: PubMed, Ovid/Embase, and the Cochrane Library were searched for studies comparing the clinical outcomes between the healed groups and the non-healed groups after RSA.Results: For functional outcomes, the results showed that the healed group had better Constant scores (CSs) (p < 0.0001). For ROM, the healed group showed better flexion (p < 0.0001), abduction (p = 0.02), and external rotation (p < 0.00001) of shoulder. For the design of prosthesis, the mean healing rate of greater tuberosity (82.7%) in patients with fracture-dedicated prosthesis was higher than those (63.0%) in patients with standard prosthesis. Subgroup analyses showed that the CS (p = 0.12) and abduction (p = 0.96) of patients using fracture-dedicated prostheses were not different between the healed groups and the non-healed groups. Meta-regression showed that there was no significant relationship between the design of prosthesis and CS (p = 0.312), flexion (p = 0.422), or external rotation (p = 0.776).Conclusion: Our meta-analysis showed that the healed groups could obtain better functional outcomes and ROM than the non-healed groups. In addition, fracture-dedicated prostheses promoted the healing rate of greater tuberosity.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020157276, PROSPERO: CRD42020157276.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Fracture-Dedicated Prosthesis Promotes the Healing Rate of Greater Tuberosity in Reverse Shoulder Arthroplasty: A Meta-Analysis

Liao

Guo

et al. 2021

Front. Surg.

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“…After screening, 277 documents were excluded, thus including 46 for full-text review. Of these 46 references, 25 were excluded and 21 studies were included in the final evidence tables [18][19][20][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47]. Table 1 shows the level of evidence of the selected studies.…”

Section: Resultsmentioning

confidence: 99%

“…One of these studies had a significant difference. Better results were observed in patients that had fractures with tuberosity union compared to a group of patients with tuberosity malunion [35]. Sixteen of the 21 studies considered other results, highlighting their frequency on the UCLA Shoulder Rating Scale (UCLA) in two studies, Disabilities of the Arm, Shoulder and Hand (DASH) or QuickDASH in six studies and on Visual Analog Scale (VAS) in four studies.…”

Section: Zafra Et Al 2014mentioning

confidence: 99%

Safety and Effectiveness of Shoulder Arthroplasties in Spain: A Systematic Review

Torre

García

Smith

et al. 2019

JCM

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The effectiveness and safety of shoulder arthroplasties in the general context of a Spanish patient population remains unclear. The aim of this study was to ascertain both the effectiveness and safety of primary shoulder arthroplasties and the prosthesis types used in Spain. A systematic review of all the available literature evaluating the effectiveness and safety of primary shoulder arthroplasties in Spain was performed. A narrative synthesis was performed, and evidence tables were created in four dimensions: study design, arthroplasty characteristics, safety, and effectiveness. Orthopaedic Data Evaluation Panel (ODEP) scores were used to evaluate prosthesis types. Twenty-one studies were selected that included a total of 1293 arthroplasties. The most common indication was fractures, while the prosthesis most frequently used was the Delta Xtend (ODEP 10A). The most common complication was scapular notching. Prosthesis revision rate was approximately 6% for follow-ups between 12 and 79 months. In addition, significant improvements were observed in the Constant–Murley test score after the intervention. Currently in Spain, shoulder arthroplasty can be considered a safe and effective procedure with functional recovery and pain reduction for eligible patients with humeral fracture, rotator cuff arthropathy, fracture sequelae and malunion of the proximal humerus, and degenerative disease. Future longitudinal research and population-based studies could serve to confirm these results and identify points of improvement.

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“…This biomechanical model led to a belief that failure of tuberosity healing would be less debilitating in RTSA than hemiarthroplasty where it was a key variable determining clinical and functional outcomes [26]. However, recent studies have highlighted that tuberosity healing, as in hemiarthroplasty, is a significant outcome variable in RTSA performed in complex proximal humerus fractures [27][28][29][30][31]. The tuberosity healing rate ranges from 37 to 90% in RTSA [32][33][34][35].…”

Section: Importance Of Tuberosity Healing On Functionmentioning

confidence: 99%

Prosthesis Designs and Tuberosity Fixation Techniques in Reverse Total Shoulder Arthroplasty: Influence on Tuberosity Healing in Proximal Humerus Fractures

Borbas

Grubhofer

et al. 2021

JCM

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Reverse total shoulder arthroplasty (RTSA) is increasingly used for the treatment of complex proximal humerus fractures and fracture sequelae. In 2021, half a dozen models of fracture stems are commercially available, reflecting its growing utility for fracture management. Prosthesis designs, bone grafting and tuberosity fixation techniques have evolved to allow better and more reliable fixation of tuberosities and bony ingrowth. Patients with anatomical tuberosity healing not only have an increased range of active anterior elevation and external rotation, but also experience fewer complications and longer prosthesis survival. This review provides an overview of recent evidence on basic and fracture-specific RTSA design features as well as tuberosity fixation techniques that can influence tuberosity healing.

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Early outcomes of locked noncemented stems for the management of proximal humeral fractures: a comparative study

Cited by 21 publications

References 37 publications

Fracture-Dedicated Prosthesis Promotes the Healing Rate of Greater Tuberosity in Reverse Shoulder Arthroplasty: A Meta-Analysis

Fracture-Dedicated Prosthesis Promotes the Healing Rate of Greater Tuberosity in Reverse Shoulder Arthroplasty: A Meta-Analysis

Safety and Effectiveness of Shoulder Arthroplasties in Spain: A Systematic Review

Prosthesis Designs and Tuberosity Fixation Techniques in Reverse Total Shoulder Arthroplasty: Influence on Tuberosity Healing in Proximal Humerus Fractures

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