Grammont versus lateralizing reverse shoulder arthroplasty for proximal humerus fracture: functional and radiographic outcomes

Verdano, Michele Arcangelo; Aliani, Davide; Galavotti, Cristina; Maroun, Charbel; Vaienti, Enrico; Ceccarelli, Francesco

doi:10.1007/s12306-018-0565-5

Cited by 16 publications

(32 citation statements)

References 44 publications

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“…In general, tuberosity healing in RSA can be dependent on many different factors like humeral inclination, lateralisation, torsion of the humeral component, retroversion of the glenoid component, or the tuberosity fixation technique [ 21 , 25 , 26 , 27 , 28 , 29 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

Fracture-Specific and Conventional Stem Designs in Reverse Shoulder Arthroplasty for Acute Proximal Humerus Fractures—A Retrospective, Observational Study

Imiolczyk

Moroder

Scheibel

2021

JCM

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Tuberosity healing and stem design can be outcome-dependent parameters in hemiarthroplasty for proximal humerus fractures (PHF). The relevance of fracture-specific stem design in reverse shoulder arthroplasty (RSA) is still a matter of debate. This retrospective study evaluates tuberosity healing and function for fracture specific stems (A) compared to conventional stems (B) in RSA for complex PHF in 26 patients (w = 21, mean age 73.5 years). Clinically, range of motion (ROM), Constant-Murley-Score (CS), Subjective Shoulder Value (SSV), and external rotation lag signs (ERLS) were evaluated. Healing of greater tuberosity (GT) and lesser tuberosity (LT), scapular notching, and loosening were examined radiologically. There were no statistical significant differences with regards to CS (A: 73 ± 11; B: 77 ± 9 points), SSV (A: 78% ± 11%; B: 84% ± 11%), external rotation (A: 18° ± 20°; B: 24° ± 19°), or internal rotation (A: 5.7 ± 2.2; B: 6.7 ± 2.8 CS-points) (p > 0.05). Mean forward flexion was superior for group A (p = 0.036). Consolidation of GT (82%) and LT (73%) was similar in both groups. Anatomical healing was slightly higher in group B (p > 0.05). Scapular notching was found in 27% (A) and 55% (B) (p > 0.05). RSA for PHF provides good to excellent clinical results. The quantitative and qualitative union rate for both cohorts was similar, indicating that fracture stems with open metaphyseal designs to allow for bone ingrowth do not improve tuberosity healing. ERLS correlates with a worse function in CS and ROM in all planes.

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Section: Introductionmentioning

confidence: 99%

Fracture-Specific and Conventional Stem Designs in Reverse Shoulder Arthroplasty for Acute Proximal Humerus Fractures—A Retrospective, Observational Study

Imiolczyk

Moroder

Scheibel

2021

JCM

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“…4,37 A posição do polietileno inlay em relação à haste também aparentemente contribui para a maior integração dos tubérculos. 38,39 Além disso, para a realização de uma ARO, existem no mercado implantes com desenhos que permitem lateralizar ou medializar o centro de rotação da articulação do ombro. Um estudos comparativo 38 sugere que a lateralização do centro de rotação da articulação e um menor ângulo cervico-diafisário melhoram a função dos músculos que atuam na rotação externa do ombro, melhorando os resultados clínicos quanto à mobilidade de rotação lateral nas AROs.…”

Section: Fatores Que Influenciam Os Resultadosunclassified

“…Esse trabalho, com as limitações próprias desse tipo de revisão, não esclarece qual deveria ser o implante a ser utilizado nos pacientes. [39][40][41] A ARO para o tratamento de fraturas é tradicionalmente realizada com componentes umerais cimentados. A literatura sugere que componentes umerais não cimentados nas AROs para o tratamento de fraturas apresentam resultados inferiores de acordo com os escores subjetivos, apesar de não existir correlação com a dor, mobilidade e consolidação do tubérculo.…”

Section: Fatores Que Influenciam Os Resultadosunclassified

Artroplastia do ombro no tratamento das fraturas da extremidade proximal do úmero: Conceitos atuais

Filho

Amaral

2021

Rev Bras Ortop (Sao Paulo)

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ResumoFraturas complexas da extremidade proximal do úmero, especialmente em idosos, frequentemente necessitam de tratamento cirúrgico artroplástico. Tradicionalmente, a hemiartroplastia (HA) do ombro é o método de escolha, com longa sobrevida do implante, e oferece um ombro indolor, mas com resultados clínicos heterogêneos, relacionados ao correto posicionamento do implante quanto à altura e à versão, além da consolidação anatômica dos tubérculos. Atualmente, a utilização de artroplastias reversas do ombro para o tratamento dessas fraturas vêm aumentando exponencialmente, com melhores resultados funcionais do que as HAs, principalmente quanto à flexão anterior, apesar de a longevidade do implante ainda não ter sido estabelecida. O desenvolvimento de componentes umerais protéticos específicos para o tratamento de fraturas, introduzidos na prática clínica nos últimos anos, levou a resultados clínicos melhores.

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“…Quality assessment using the Newcastle-Ottawa scale was good for all papers with the exception of Verdano et al 2018, which had a follow-up period of only six months and excluded patients who were not compliant with physiotherapy and did not describe demographics [ 30 ]. In a sensitivity test, the removal of the Verdano et al study paper did not significantly impact the outcome of results [ 30 ].…”

Section: Reviewmentioning

confidence: 99%

“…Scapular notching was the most frequent complication presented in all but one paper, Boutsiadis et al (2018), which did not report post-operative complications [ 24 ]. Heterotrophic ossification was reported in three papers [ 27 , 30 - 31 ] with a total of 35 cases in the lateralised group and 54 cases in the medialised group [ 27 , 30 - 31 ]. Poisetty et al [ 28 ] reported bone resorption in both groups; greater tuberosity (GT) and calcar resorption occurred in 34 and 18 patients, respectively, for the lateralised group, with the medialised group having 13 for GT and only one for calcar.…”

Section: Reviewmentioning

confidence: 99%

Reverse Shoulder Arthroplasty Humeral Lateralisation: A Systematic Review

Dhillon¹,

Warren²,

Assiotis³

et al. 2021

Cureus

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Grammont versus lateralizing reverse shoulder arthroplasty for proximal humerus fracture: functional and radiographic outcomes

Cited by 16 publications

References 44 publications

Fracture-Specific and Conventional Stem Designs in Reverse Shoulder Arthroplasty for Acute Proximal Humerus Fractures—A Retrospective, Observational Study

Fracture-Specific and Conventional Stem Designs in Reverse Shoulder Arthroplasty for Acute Proximal Humerus Fractures—A Retrospective, Observational Study

Artroplastia do ombro no tratamento das fraturas da extremidade proximal do úmero: Conceitos atuais

Reverse Shoulder Arthroplasty Humeral Lateralisation: A Systematic Review

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