Long-Term Outcomes of Reverse Total Shoulder Arthroplasty

Bacle, Guillaume; Nové-Josserand, Laurent; Garaud, P.; Walch, Gilles

doi:10.2106/jbjs.16.00223

Cited by 317 publications

(176 citation statements)

References 26 publications

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“…Even if the author encouraged caution in using a reverse prosthesis in young patients because of degradation of functional results, an important factor in his study is also the cause of the shoulder dysfunction; failure of a previous implant and posttraumatic arthritis are associated with a greater decrease in functional outcomes, whereas CTA and primary osteoarthritis have the best long-term results, with preserved mobility and active anterior elevation. 2 Despite these considerations, today there is a tendency to extend the indications to younger patients.…”

Section: Discussionmentioning

confidence: 99%

“…outcomes 7,8,12,15,43,48 that seem to persist in long-term studies. 2,23,43 A reduction in active external and internal rotation and scapular notching were underlined as the limits of Grammont's classic design. 6,7,46 Several biomechanical studies showed that increasing the lateral offset is an effective solution in recovering rotational movement and avoiding scapular notching.…”

mentioning

confidence: 99%

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Clinical results of bony increased-offset reverse shoulder arthroplasty (BIO-RSA) associated with an onlay 145° curved stem in patients with cuff tear arthropathy: a comparative study

Franceschetti

Ranieri

Sanctis

et al. 2020

Journal of Shoulder and Elbow Surgery

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Clinical results of bony increased-offset reverse shoulder arthroplasty (BIO-RSA) associated with an onlay 145° curved stem in patients with cuff tear arthropathy: a comparative study

Franceschetti

Ranieri

Sanctis

et al. 2020

Journal of Shoulder and Elbow Surgery

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“…Furthermore, the significant differences in measured peak elevation muscle moment arms between the anatomic and reverse shoulder varied from 7.7 mm (superior infraspinatus during abduction) to 21.5 mm (middle deltoid during flexion). The combined changes in moment arms of these and other shoulder muscles are likely to be the primary contributor to the marked differences in estimated muscle recruitment patterns and glenohumeral joint force following RSA, which have been shown to be clinically relevant …”

Section: Discussionmentioning

confidence: 99%

Muscle and Joint Function After Anatomic and Reverse Total Shoulder Arthroplasty Using a Modular Shoulder Prosthesis

Ackland

Thomas

Patel

et al. 2019

Journal Orthopaedic Research

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Changes in joint architecture and muscle loading resulting from total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RSA) are known to influence joint stability and prosthesis survivorship. This study aimed to measure changes in muscle moment arms, muscle lines of action, as well as muscle and joint loading following TSA and RSA using a metal-backed uncemented modular shoulder prosthesis. Eight cadaveric upper extremities were assessed using a customized testing rig. Abduction, flexion, and axial rotation muscle moment arms were quantified using the tendon-excursion method, and muscle line-of-force directions evaluated radiographically pre-operatively, and after TSA and revision RSA. Specimen-specific musculoskeletal models were used to estimate muscle and joint loading pre-and post-operatively. TSA lateralized the glenohumeral joint center by 4.3 ± 3.2 mm, resulting in small but significant increases in middle deltoid force (2.0%BW) and joint compression during flexion (2.1% BW) (p < 0.05). Revision RSA significantly increased the moment arms of the major abductors, flexors, adductors, and extensors, and reduced their peak forces (p < 0.05). The superior inclination of the deltoid significantly increased while the inferior inclination of the rotator cuff muscles decreased (p < 0.05). TSA using an uncemented metal-backed modular shoulder prosthesis effectively restores native joint function; however, lateralization of the glenoid component should be minimized intra-operatively to mitigate increased glenohumeral joint loading and polyethylene liner contact stresses. Revision RSA reduces muscle forces required during shoulder function but produces greater superior joint shear force and less joint compression. The findings may help to guide component selection and placement to mitigate joint instability after arthroplasty.

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“…4 Long term results have been reported and continue to be evaluated. 5 From an economic standpoint, studies have shown RTSA to be more cost-effective than Total Shoulder Arthroplasty (TSA) and Hemi-arthroplasty (HA) with respect to cost of implant and low rate of complication from the surgery. [6][7][8] Anecdotally, we have noticed patients with a complaint of limited range of motion at the end of one year possibly due to the delay in the onset of shoulder motion.…”

Section: Introductionmentioning

confidence: 99%

Accelerated Shoulder Rehabilitation after Reverse Total Shoulder Arthroplasty for Atraumatic Osteoarthritis: Study Protocol for a Single Center Randomized Controlled Trial

Raja¹,

Cambronne²,

Mr³

2019

Preprint

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Background Reverse total shoulder arthroplasty has been successful in patients suffering from advanced degenerative osteoarthritis with rotator cuff insufficiency. The currently practiced physical rehabilitation after a shoulder rehabilitation does not allow shoulder motion until 6 weeks post-operatively. These patients are required to be in a sling to assist the patient in immobilizing the operated shoulder. An accelerated rehabilitation with immediate active shoulder motion has not been studied in the setting of a revere total shoulder arthroplasty. Methods This is a single center and single surgeon operated, randomized controlled trial. The primary objective is to compare patient reported shoulder function using the American Shoulder and Elbow Society (ASES) score and shoulder range of motion in patients undergoing the traditional physical rehabilitation and accelerated shoulder rehabilitation post reverse total shoulder arthroplasty. Secondary outcomes will include the Simple Shoulder Test (SST) score, Patient Reported Outcome Information System (PROMIS) Global Health-10, radiological parameters and subscapularis tear on ultrasound. Discussion The study will assess the effectiveness of an accelerated shoulder rehabilitation with immediate active shoulder motion after a reverse total shoulder arthroplasty in patients with atraumatic osteoarthritis.

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Long-Term Outcomes of Reverse Total Shoulder Arthroplasty

Abstract: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Cited by 317 publications

References 26 publications

Clinical results of bony increased-offset reverse shoulder arthroplasty (BIO-RSA) associated with an onlay 145° curved stem in patients with cuff tear arthropathy: a comparative study

Clinical results of bony increased-offset reverse shoulder arthroplasty (BIO-RSA) associated with an onlay 145° curved stem in patients with cuff tear arthropathy: a comparative study

Muscle and Joint Function After Anatomic and Reverse Total Shoulder Arthroplasty Using a Modular Shoulder Prosthesis

Accelerated Shoulder Rehabilitation after Reverse Total Shoulder Arthroplasty for Atraumatic Osteoarthritis: Study Protocol for a Single Center Randomized Controlled Trial

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