Outcomes of hemiarthroplasty for fractures of the proximal humerus

Mighell, Mark A.; Kolm, Gerald P; Collinge, Cory; Frankle, Mark A.

doi:10.1016/s1058-2746(03)00213-1

Cited by 261 publications

(204 citation statements)

References 34 publications

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“…Kettler et al reported a rate of 42% [17], which is comparable to our results. We did not find any specification regarding revision rate for primary HA in Neer Group VI fractures in the literature [3,5,19,21,22,27].…”

Section: Discussionmentioning

confidence: 78%

“…Hertel's eggshell model provides a possible explanation for this observation [13]. Concerning final malunion, absorption, and nonunion of the greater tuberosity the literature varies from 21% to 53% for primary HA of displaced three-and four-part fractures [5,19,21,22]. We explain our comparatively high incidence of mainly radiographic complications with strict analysis of the greater tuberosity, the acromiohumeral distance, and the complexity of the Neer group VI fractures, which are only partially included in other studies [3,5,19,21,22,27].…”

Section: Discussionmentioning

confidence: 85%

“…With these implants, better biomechanical stability could be achieved [16]. Anatomic reconstruction for severely displaced fractures and fractures with glenohumeral dislocations aiming to achieve superior function compared with primary HA has been reported [2,11,12,17,20,22,28].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical Treatment of Neer Group VI Proximal Humeral Fractures: Retrospective Comparison of PHILOS® and Hemiarthroplasty

Spross

Platz

Erschbamer

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 85%

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Surgical Treatment of Neer Group VI Proximal Humeral Fractures: Retrospective Comparison of PHILOS® and Hemiarthroplasty

Spross

Platz

Erschbamer

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…If a prosthesis fails, however, because of loosening, infection, instability, glenoid wear, or rotator cuff dysfunction, serious challenges can arise [1,4,11,16,22,24,28,31]. If revision is uncertain to preserve or restore clinically satisfactory cuff function, conversion to reverse total shoulder arthroplasty has become the preferred treatment, especially for elderly patients [8,20,23,33].…”

Section: Introductionmentioning

confidence: 99%

Conversion of Stemmed Hemi- or Total to Reverse Total Shoulder Arthroplasty: Advantages of a Modular Stem Design

Wieser

Borbas

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background If revision of a failed anatomic hemiarthroplasty or total shoulder arthroplasty is uncertain to preserve or restore satisfactory rotator cuff function, conversion to a reverse total shoulder arthroplasty has become the preferred treatment, at least for elderly patients. However, revision of a well-fixed humeral stem has the potential risk of loss of humeral bone stock, nerve injury, periprosthetic fracture, and malunion or nonunion of a humeral osteotomy with later humeral component loosening. Questions/purposes The purposes of this study were to determine whether preservation of a modular stem is associated with (1) less blood loss and operative time; (2) fewer perioperative and postoperative complications, including reoperations and revisions; and/or (3) improved Constant and Murley scores and subjective shoulder values for conversion to a reverse total shoulder arthroplasty compared with stem revision. Methods Between 2005 and 2011, 48 hemiarthroplasties and eight total shoulder arthroplasties (total = 56 shoulders; 54 patients) were converted to an Anatomical TM reverse total shoulder arthroplasty system without (n = 13) or with (n = 43) stem exchange. Complications and revisions for all patients were tallied through review of medical and surgical records. The outcomes scores included the Constant and Murley score and the subjective shoulder value. Complete clinical followup was available on 80% of shoulders (43 patients; 45 of 56 procedures, 32 with and 13 without stem exchange) at a minimum of 12 months (mean, 37 months; range, 12-83 months). Results Blood loss averaged 485 mL (range, 300-700 mL; SD, 151 mL) and surgical time averaged 118 minutes (range, 90-160 minutes; SD, 21 minutes) without stem exchange and 831 mL (range, 350-2000 mL; SD, 400 mL) and 176 minutes (range, 120-300 minutes; SD, 42 minutes) with stem exchange (p = 0.001). Intraoperative complications (8% versus 30%; odds ratio [OR], 5.2) and reinterventions (8% versus 14%; OR, 1.9) were substantially fewer in patients without stem exchange. The complication rate leading to dropout from the study was substantial in the stem revision group (six patients; 43 shoulders [14%]), but there were no complication-related dropouts in the stemretaining group. If, however, such complications could be avoided, with the numbers available we detected no difference in the functional outcome between the two groups. Conclusions Patients undergoing revision of stemmed hemiarthroplasty or total to reverse total shoulder arthroplasty without stem exchange had less intraoperative blood loss and operative time, fewer intraoperative complications, and fewer revisions than did patients whose index revision procedures included a full stem exchange.

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“…Compito et al [2], however, only observed an excellent result rate in 48.5 % of their patients. In recent years, good pain relief has been consistently reported in the literature [10][11][12][13], but the post-operative shoulder range of motion and functional outcomes have been less satisfying [10][11][12]. In a multicentre, retrospective study of 167 patients by Kralinger et al [14], only 41.9 % of the patients demonstrated a postoperative forward elevation of over 90°.…”

Section: Discussionmentioning

confidence: 99%

Trabecular metal™ shoulder prosthesis in the treatment of complex proximal humeral fractures

Jiang

2013

International Orthopaedics (SICOT)

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Purpose Shoulder arthroplasty is one of the options for the treatment of complex proximal humeral fractures. The purpose of this study was to assess the clinical and radiographic results of the trabecular metal shoulder prosthesis in the treatment of complex proximal humeral fractures. Methods Fifty-one consecutive patients with complex proximal humeral fractures who underwent primary shoulder arthroplasties with the trabecular metal™ prosthesis were enrolled in this study. At the final follow-up appointment, 42 of the patients (82.4 % of the total patients enrolled) were available for both clinical and radiographic evaluation. There were 28 women and 14 men with a mean age of 65.4±10.7 years. The dominant arm was involved in 30 of the cases. According to Neer's classification, there were seven three-part fractures, 27 four-part fractures and eight head-splitting fractures. Additionally, there were 37 hemiarthroplasties and five total shoulder arthroplasties.Results After a mean follow-up of 37.0±8.4 months (range 24-52 months), the average ranges of motion were: 38.6±15.0°f or external rotation, L3 level for internal rotation and 132.3±36.0°for forward elevation. The mean American Shoulder and Elbow Surgeons, visual analogue scale and University of California, Los Angeles scores were 82.1±14.1, 0.4±1.1 and 28.8±5.1, respectively. The post-operative radiographs exhibited an anatomically attached greater tuberosity in 39 of the 42 shoulders. Of the three patients with greater tuberosity complications, as displayed by their radiographs, two were observed with malpositioned tuberosities, while the other greater tuberosity was resorbed. Proximal migration of the prosthesis was observed in all three shoulders with greater tuberosity complications and in two shoulders with an anatomically attached greater tuberosity. No neurovascular injury, infection or prosthetic loosening was identified during the final follow-up appointments.Conclusions Satisfactory results can be expected with the trabecular metal shoulder prosthesis for the treatment of complex proximal humeral fractures. The post-operative radiographs demonstrated an anatomically healed greater tuberosity in 93 % of the patients at a minimum follow-up time of two years.

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Outcomes of hemiarthroplasty for fractures of the proximal humerus

Cited by 261 publications

References 34 publications

Surgical Treatment of Neer Group VI Proximal Humeral Fractures: Retrospective Comparison of PHILOS® and Hemiarthroplasty

Surgical Treatment of Neer Group VI Proximal Humeral Fractures: Retrospective Comparison of PHILOS® and Hemiarthroplasty

Conversion of Stemmed Hemi- or Total to Reverse Total Shoulder Arthroplasty: Advantages of a Modular Stem Design

Trabecular metal™ shoulder prosthesis in the treatment of complex proximal humeral fractures

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