Pearls and Tips in Shoulder Arthroplasty

Sperling, John W.

doi:10.4055/cios.2019.11.3.258

Cited by 12 publications

(7 citation statements)

References 13 publications

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“…Many surgical procedures have been introduced for the treatment of irreparable RCTs: arthroscopic debridement, 27 tuberoplasty, 16 , 54 partial repair, 3 interposition grafting (IG), 41 , 46 superior capsular reconstruction (SCR), 34 tendon transfers, 15 , 17 reverse total shoulder arthroplasty, 6 , 39 , 50 and arthrodesis. 11 Among these surgical procedures, IG and SCR are 2 of the most commonly performed.…”

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confidence: 99%

Clinical Outcomes of Interposition Graft Versus Superior Capsular Reconstruction in Patients With Irreparable Rotator Cuff Tears: A Systematic Review and Meta-analysis

Baek

Shin

Kim

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Interposition grafting (IG), also called bridging grafting, and superior capsular reconstruction (SCR) are the most commonly used joint-preserving surgical methods for irreparable rotator cuff tears (RCTs). Purpose: To compare the effectiveness of IG versus SCR to treat patients with irreparable RCTs. Study Design: Systematic review; Level of evidence, 4. Methods: A literature search was performed in MEDLINE, Embase, and Scopus. Included in this review were clinical studies evaluating the effect of IG or SCR in patients with irreparable RCTs with a minimum follow-up of 1 year. Various clinical results from the studies were extracted and compared between IG and SCR, and among them, the results of the American Shoulder and Elbow Surgeons score, graft retear rate, and complication rate were included in the meta-analysis. Results: Of 1638 identified articles, 17 (10 studies of IG involving 321 patients and 7 studies of SCR involving 357 patients) were selected. Both surgical methods showed significantly improved clinical outcomes in all but 1 study; however, the IG group had lower pain visual analog scale score, higher Constant score, and bigger active forward flexion and internal rotation compared with the SCR group (all P < .001). The meta-analysis showed no difference in the American Shoulder and Elbow Surgeons score between groups ( P = .44), but showed a significantly lower complication rate in the IG group compared with the SCR group (1.12% vs 8.37%, respectively; P < .001). The graft retear rate was not significantly different between groups (IG = 10.64% vs SCR = 12.67%; P = .79). The meta-analysis of graft type indicated no difference between groups in retear rate (autograft: 95% CI, 0.045-0.601; I2 = 93.28 [IG], 91.27 [SCR]; P = .22; allograft: 95% CI, 0.041-0.216; I2 = 80.39 [IG], 69.12 [SCR]; P = .64) or complication rate (autograft: 95% CI, 0.009-0.150; I2 = 0 [IG], 65.89 [SCR]; P = .25; allograft: 95% CI, 0.012-0.081; I2 = 0 [IG], 30.62 [SCR]; P = .09). Conclusion: Both IG and SCR techniques resulted in improvement in patients with irreparable RCTs. Meta-analysis showed a lower complication rate in the IG group; however, the lack of randomized studies limited our conclusions.

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confidence: 99%

Clinical Outcomes of Interposition Graft Versus Superior Capsular Reconstruction in Patients With Irreparable Rotator Cuff Tears: A Systematic Review and Meta-analysis

Baek

Shin

Kim

et al. 2021

Orthopaedic Journal of Sports Medicine

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“…RTSA has been shown to have efficacy for the treatment of debilitating shoulder diseases with rotator cuff deficiency[ 4 , 9 ]. As the indications for RTSA have expanded, there has been a dramatic growth in the frequency of RTSA worldwide over the past decade[ 3 , 10 ]. In the past, bilateral RTSA was considered inadvisable because patients may struggle with ADLs following treatment[ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Simultaneous bilateral acromial base fractures after staged reverse total shoulder arthroplasty: A case report

Kim¹,

Kim²,

Cho³

2021

WJCC

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“…Similar to RDA of the hip, RDA of the shoulder may not respond well to conservative treatment. In a review of the literature, all reported cases with RDA due to SIF of the shoulder underwent arthroplasty [17]. Our cases were treated by shoulder arthroplasty (n = 17) or arthroscopic debridement (n = 3) depending on the patient's age, activity, symptoms, degree of head destruction, and presence or absence of a rotator cuff tear [18,19].…”

Section: Discussionmentioning

confidence: 99%

Rapid Destructive Arthrosis Due to Subchondral Insufficiency Fracture of the Shoulder: Clinical Characteristics, Radiographic Appearances, and Outcomes of Treatment

et al. 2020

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The purpose of our study was the clinical characteristics, radiographic appearance, and outcomes after treatment in patients with rapid destructive arthrosis (RDA) due to subchondral insufficiency fracture (SIF) of the shoulder. Twenty-two cases of RDA of the shoulder were retrospectively reviewed. Clinical outcomes for 15 cases who underwent shoulder arthroplasty were evaluated at an average of 41.4 months. The mean age of patients was 73.7 years (range 50–83 years), and there were 20 women and 2 men. The mean time from onset of symptoms to head collapse was 6.8 months (range 1–12 months). The mean t-score of bone mineral density was −3.1. Nine patients had pseudoparalysis. Based on radiographic appearance, a diversity of types of head destruction with subchondral fracture, bone marrow edema, joint effusion, and synovitis were observed in all cases. In conclusion, RDA due to SIF of the shoulder, presenting with severe short-term pain and functional disability, commonly occurred in elderly women with bone fragility. MRI revealed bone marrow edema, extensive joint effusion, and synovitis as well as a diversity of types of head destruction with subchondral fracture within several months from onset of symptoms.

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Pearls and Tips in Shoulder Arthroplasty

Cited by 12 publications

References 13 publications

Clinical Outcomes of Interposition Graft Versus Superior Capsular Reconstruction in Patients With Irreparable Rotator Cuff Tears: A Systematic Review and Meta-analysis

Clinical Outcomes of Interposition Graft Versus Superior Capsular Reconstruction in Patients With Irreparable Rotator Cuff Tears: A Systematic Review and Meta-analysis

Simultaneous bilateral acromial base fractures after staged reverse total shoulder arthroplasty: A case report

Rapid Destructive Arthrosis Due to Subchondral Insufficiency Fracture of the Shoulder: Clinical Characteristics, Radiographic Appearances, and Outcomes of Treatment

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