Prevalence of Neurologic Lesions After Total Shoulder Arthroplasty

Lädermann, Alexandre; Lübbeke, Anne; Mélis, Barbara; Stern, Richard; Christofilopoulos, Panayiotis; Bacle, Guillaume; Walch, Gilles

doi:10.2106/jbjs.j.00369

Cited by 207 publications

(163 citation statements)

References 10 publications

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“…The occurrence of neural injury following shoulder arthroplasty is rare but may be slightly increased in reverse TSA [14]. Relative arm lengthening in reverse TSA is thought to be a possible etiology for these injuries.…”

Section: Neural Pathologymentioning

confidence: 99%

“…Other reported causes include intraoperative factors such as retractor placement and interscalene nerve block, postoperative hematoma, cement extrusion, screw migration, and humeral shaft fracture [14]. Axillary neuropathy is most frequently reported in reverse TSA and is usually transient [14]. Other nerves that may be injured intraoperatively and following shoulder arthroplasty include the suprascapular nerve and the brachial plexus.…”

Section: Neural Pathologymentioning

confidence: 99%

See 1 more Smart Citation

Magnetic Resonance Imaging of Shoulder Arthroplasty

Nwawka

Konin

Sneag

et al. 2014

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: Magnetic resonance (MR) imaging evaluation of the painful failed shoulder arthroplasty is a useful imaging modality due to advancements in metal artifact reduction techniques, which allow assessment of the integrity of the supporting soft-tissue envelope and the implant. Questions/Purposes: The focus of this pictorial review is to illustrate the benefits of MR imaging, whether used alone or as an adjunct to other imaging modalities, in aiding the clinician in the complex decision making process. Methods: A PubMed (MEDLINE) search focusing on the complications and imaging assessment of shoulder arthroplasty was performed. Articles were selected for review based on their pertinence to the aforementioned topics. Results: We discuss the ability of MR imaging to identify why a patient's arthroplasty may have failed. Specific causes including component loosening and implant failure, rotator cuff and deltoid integrity, infection, subtle fractures, and nerve pathology are reviewed, with illustrative sample images. Conclusion: MRI is a valuable tool in the assessment for pathology in the shoulder following arthroplasty.

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Section: Neural Pathologymentioning

confidence: 99%

Section: Neural Pathologymentioning

confidence: 99%

Magnetic Resonance Imaging of Shoulder Arthroplasty

Nwawka

Konin

Sneag

et al. 2014

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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show abstract

“…3. Neurological complications after RTSA implantation were studied by Lädermann and colleagues [33]. This study focused on the clinical, radiographic, preoperative and post-operative electromyographic evaluation, with measurement of arm lengthening, according to a previously validated protocol.…”

mentioning

confidence: 99%

Complications with reverse total shoulder arthroplasty and recent evolutions

Scarlat¹

2013

International Orthopaedics (SICOT)

121

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Since its description by Paul Grammont from Dijon, France, several tens of thousands of reverse total shoulder arthroplasties (RTSA) have been performed for diverse conditions. The purpose of this analysis is to identify the complications of this procedure in the literature and in clinical practice. A total of 240 papers concerning RTSA published between 1996 and 2012 have been identified. Over 80 papers describe complications associated with this type of implant. A list of prostheses satisfying European and US standards, CE and FDA approved, has been produced on the basis of information provided by the manufacturers. Data from the literature do not support a meta-analysis. The inventory of best practices shows excellent results in the short and medium term in specific indications, while the number of complications varies between 10 and 65 % in long-term series. Complications can be classified into (A) non-specific including infections (superficial and deep), phlebitis, haematoma, neurological complications of the suprascapular, radial and axillary nerves and (B) specific complications associated with RTSA including (1) on the glenoid side: intraoperative fracture of the glenoid and acromion, late fracture of the scapula, impingement at the scapular neck (notching), glenoid loosening, dissociation of the glenoid component (snatching of the glenosphere) and fractures of the glenoid baseplate; (2) on the humeral side: metaphyseal deterioration, humeral loosening, instability of the shoulder, stiffness with limitation of external and/or internal rotation; and (3) muscular complications with fatty degeneration of the deltoid. Additionally we have identified specific situations related to the type of implant such as the disassembly of the humeral or the glenoid component, dissociation of the polyethylene humeral plate, dissociation of the metaphysis and osteolysis of the tuberosities. The integration of results from different clinical series is difficult because of the lack of a database and the multitude of implants used.

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“…This can be attributed to the stretch placed on the brachial plexus during humeral positioning and traction during glenoid exposure [33]. Ladderman et al found the prevalence of acute postoperative nerve injury to be significantly more frequent in RSA than in anatomic TSA due to arm lengthening in RSA [34]. In the majority of these cases, however, neurapraxia is the cause and with conservative management, symptoms will completely resolve with time.…”

Section: Nerve Injurymentioning

confidence: 99%

Management of complications after revision shoulder arthroplasty

Rahmi

Jawa

2015

Curr Rev Musculoskelet Med

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Complications after revision shoulder arthroplasty are similar to those in the primary setting which include instability, fracture, bone loss, infection, nerve injury, and loosening. Unlike in the primary setting, however, the rate of complications for revisions is significantly greater and the management is more complex because of overlapping complications and limited treatment options. Furthermore, there is a paucity of evidence-based literature to direct the management options in these patients. The purposes of this review are to broadly outline the major complications that are seen in revision shoulder arthroplasty and to provide general principles on how to recognize and approach these complex cases.

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Prevalence of Neurologic Lesions After Total Shoulder Arthroplasty

Abstract: The occurrence of peripheral neurologic lesions following reverse shoulder arthroplasty is relatively common, but usually transient. Arm lengthening with a reverse shoulder arthroplasty may be responsible for these nerve injuries.

Cited by 207 publications

References 10 publications

Magnetic Resonance Imaging of Shoulder Arthroplasty

Magnetic Resonance Imaging of Shoulder Arthroplasty

Complications with reverse total shoulder arthroplasty and recent evolutions

Management of complications after revision shoulder arthroplasty

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