How common is nerve injury after reverse shoulder arthroplasty? A systematic review

North, Decorian; Hones, Keegan M.; Jenkins, Preston; Sipavicius, Edvinas; Salinas, José L. Zermeño; Hao, Kevin A.; Schoch, Bradley S.; Wright, Thomas W.; Gulotta, Lawrence V.; King, Joseph J.

doi:10.1016/j.jse.2022.10.022

Cited by 5 publications

(4 citation statements)

References 209 publications

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“…Similarly, our nerve-related complication incidence, including transient neuropraxias and nerve injuries, was 3.1%. This is nearly 3 times higher than the 1.3% rate reported for primary RSA by a recent systematic review 61 and consistent with the 2% to 4% rate reported for LDT alone by Moursy et al 62 . Dislocation is another concern with LDT, with our review finding a dislocation rate of 3.1%.…”

Section: Discussionsupporting

confidence: 87%

“…Constant score based on implant design was available for 5 cohorts with lateralized (n 5 92) and 6 cohorts with medialized (n 5 61) implants (Fig. 4-A); no difference in postoperative Constant score was found (64 [60][61][62][63][64][65][66][67] vs. 67 [64][65][66][67][68][69][70], p 5 0.185). Comparison of postoperative Constant score based on whether concomitant TMT was performed was available for 7 cohorts that used LDT-only (n 5 82) and 6 cohorts that used LDT-TMT (n 5 109) (Fig.…”

Section: Comparison Of Postoperativementioning

confidence: 99%

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Outcomes of Reverse Total Shoulder Arthroplasty with Latissimus Dorsi Tendon Transfer for External Rotation Deficit

Hones¹,

Rakauskas²,

Wright³

et al. 2023

JBJS Reviews

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Background: Latissimus dorsi transfer (LDT) has been purported to restore motion in patients undergoing reverse shoulder arthroplasty (RSA) who have preoperative combined loss of forward elevation (FE) and external rotation (ER). This systematic review summarizes the available evidence for the functional outcomes and complications after RSA with LDT. Furthermore, the effect of implant design and whether a concomitant teres major transfer (TMT) was performed were studied.Methods: A systematic review was performed per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We queried PubMed/MEDLINE, Embase, Web of Science, and Cochrane databases to identify articles reporting on LDT with RSA to restore ER. Our primary outcomes were ER, FE, Constant score, and complication incidence. Secondarily, we reported postoperative internal rotation (IR) and compared ER, FE, and Constant score based on lateralized versus medialized global implant design and whether concomitant TMT was performed.Results: Nineteen studies were evaluated; functional outcomes were assessed in 16 articles reporting on 258 RSAs (123 LDT, 135 LDT-TMT). Surgical indication was most commonly cuff tear arthropathy and massive irreparable cuff tear. Mean ER was 212°preoperatively and 25°postoperatively, FE was 72°preoperatively and 141°postoperatively. Mean postoperative Constant score was 65. Of 138 patients (8 studies) describing IR, only 25% reported a mean postoperative IR $L3. Subanalysis comparing lateralized versus medialized implants and whether TMT was concomitantly performed demonstrated no significant difference in postoperative ER, FE, and Constant score, nor preoperative to postoperative improvement in ER and FE. The complication rate was 14.1% (of 291 shoulders from 16 studies), including tear in the tendon transfer (n 5 3), revision tendon repair (n 5 1), nerve-related complication (n 5 9), and dislocation (n 5 9).Conclusions: RSA with LDT is a reliable option to restore motion, with a comparable complication rate with standard RSA. The use of medialized versus lateralized implants and whether the TM was concomitantly transferred may not influence clinical outcomes.Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSREV/A974).

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Section: Discussionsupporting

confidence: 87%

Section: Comparison Of Postoperativementioning

confidence: 99%

Outcomes of Reverse Total Shoulder Arthroplasty with Latissimus Dorsi Tendon Transfer for External Rotation Deficit

Hones¹,

Rakauskas²,

Wright³

et al. 2023

JBJS Reviews

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“…Several studies have analysed neurological complications during [ 6 , 7 ] or after [ 8 – 10 ]. RSA, but none focus on the patient’s preoperative neurological situation.…”

Section: Discussionmentioning

confidence: 99%

“…Comparison with other studies is difficult, since previous papers have not clearly defined the electrodiagnostic criteria for nerve injuries. Furthermore, the prevalence of SSN has been reported to be between 8 and 42% [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Neuropathy of the suprascapular and axillary nerves in rotator cuff arthropathy: a prospective electrodiagnostic study

Lopiz,

Rodríguez-González,

Martín-Albarrán

et al. 2024

International Orthopaedics (SICOT)

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Purpose Prevalence of axillary (AN) and/or suprascapular (SSN) neuropathy in rotator cuff tear arthropathy (RCTA) is unknown. We aimed to prospectively evaluate for preoperative neurodiagnostic abnormalities in order to determine their prevalence, location, and influence on reverse shoulder arthroplasty (RSA) outcomes. Methods Patients who underwent RSA for RCTA were prospectively included. An electromyography and nerve conduction study were performed pre and post-surgery. Clinical situation: VAS, Relative Constant-Murley Score (rCMS) and ROM over a minimum of two years follow-up. Results Forty patients met the inclusion criteria; mean follow-up was 28.4 months (SD 4.4). Injuries in RCTA were present in 83.9% (77.4% in AN and 45.2% in SSN). There were no differences on preoperative VAS, ROM, and rCMS between patients with and without preoperative nerve injuries. Four acute postoperative neurological injuries were registered under chronic preoperative injuries. Six months after RSA, 69% of preoperative neuropathies had improved (82.14% chronic injuries and 77.7% disuse injuries). No differences in improvement between disuse and chronic injuries were found, but patients with preoperative neuropathy that had not improved at the postoperative electromyographic study at six months, scored worse on the VAS (1.44 vs 2.66; p .14) and rCMS (91.6 vs 89.04; p .27). Conclusions The frequency of axillary and suprascapular neuropathies in RCTA is much higher than expected. Most of these injuries improve after surgery, with almost complete neurophysiological recovery and little functional impact on RSA. However, those patients with preoperative neuropathies and absence of neurophysiological improvement six months after surgery have lower functional results.

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Can ChatGPT answer patient questions regarding reverse shoulder arthroplasty?

Lack,

Mouhawasse,

Childers

et al. 2024

Journal of ISAKOS

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How common is nerve injury after reverse shoulder arthroplasty? A systematic review

Cited by 5 publications

References 209 publications

Outcomes of Reverse Total Shoulder Arthroplasty with Latissimus Dorsi Tendon Transfer for External Rotation Deficit

Outcomes of Reverse Total Shoulder Arthroplasty with Latissimus Dorsi Tendon Transfer for External Rotation Deficit

Neuropathy of the suprascapular and axillary nerves in rotator cuff arthropathy: a prospective electrodiagnostic study

Can ChatGPT answer patient questions regarding reverse shoulder arthroplasty?

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