Primary reverse shoulder arthroplasty: how did medialized and glenoid-based lateralized style prostheses compare at 10 years?

Kennon, Justin C.; Songy, Chad E.; Bartels, D; Statz, Joseph M.; Cofield, Robert H.; Sperling, John W.; Sánchez-Sotelo, Joaquín

doi:10.1016/j.jse.2019.11.004

Cited by 26 publications

(41 citation statements)

References 16 publications

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“…In only about 50% of the major studies on this topic, the surgery was performed by a single surgeon [12][13][14]. As it is a proven fact that functional outcomes after surgery are dependent on the surgeon's experience and learning curve, as well as intraoperative decisions concerning prosthesis design, soft-tissue management, and rehab program after surgery [27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Results after primary reverse shoulder arthroplasty with and without subscapularis repair: a prospective-randomized trial

Engel

Holschen²,

Schorn

et al. 2021

Arch Orthop Trauma Surg

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Introduction Indications for reverse shoulder arthroplasties (rTSA) have increased since their development by Paul Grammont in 1985. Prosthesis design was enhanced over time, but the management of the tendon of the M. subscapularis (SSC-tendon) in primary rTSA is still a controversial subject with regard to perform a refixation or not. Methods 50 patients were randomized in a refixation group (A) and a non-refixation-group (B) of the SSC-tendon in a double-blinded fashion. SSC-function was assessed at baseline before surgery, such as 3 and 12 months after surgery. Constant–Murley-Shoulder Score (CS), American Shoulder and Elbow Surgeons Score (ASES), strength, range of motion (ROM), and pain on numeric rating scale (NRS) were measured in all examinations. An ultrasound examination of the shoulder was performed for evaluation of subscapularis tendon integrity at 3 and 12 month follow-up visits. Pain was evaluated on NRS via phone 5 days after surgery. Surgery was performed by a single experienced senior surgeon in all patients. Results Patients with a refixation of the SSC-tendon and primary rTSA had improved internal rotation [40° (20°–60°) vs. 32° (20°–45°); p = 0.03] at 12 months of follow-up. Additionally, the A-group had increased CS [74 (13–90) vs. 69.5 (40–79); p = 0.029] 1 year after surgery. Results were strengthened by subgroup analysis of successful refixation in ultrasound examination vs. no refixation. No differences were seen in ASES and NRS 1 year after rTSA. Conclusion SSC-tendon repair in rTSA improves CS and internal rotation 12 months after surgery.

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Section: Discussionmentioning

confidence: 99%

Results after primary reverse shoulder arthroplasty with and without subscapularis repair: a prospective-randomized trial

Engel

Holschen²,

Schorn

et al. 2021

Arch Orthop Trauma Surg

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“…Reverse shoulder arthroplasty (RSA) was designed to improve the outcome of shoulder replacement in the setting of rotator cuff insufficiency [1••]. Although cuff-tear arthropathy was the main condition managed with RSA initially [2], indications for this procedure expanded to other disorders, including the functionally irreparable rotator cuff tear (FIRCT) without arthropathy [3]. Many people around the world with FIRCTs have benefited from RSA.…”

Section: Introductionmentioning

confidence: 99%

How to Optimize Reverse Shoulder Arthroplasty for Irreparable Cuff Tears

Sánchez-Sotelo

Athwal

2020

Curr Rev Musculoskelet Med

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Purpose of the Review Reverse shoulder arthroplasty (RSA) is commonly considered as one of the options for surgical management of the functionally irreparable rotator cuff tear (FIRCT). This article reviews tips and tricks to optimize the outcome of RSA when performed specifically for this indication. Recent Findings RSA has been reported to provide satisfactory outcomes in a large proportion of patients with FIRCTs. However, subjective satisfaction is lesser in patients with well-maintained preoperative motion as well as those with isolated loss of active external rotation. The popularity of implants that provide some degree of global lateralization continues to increase. Optimizing the outcome of RSA for FIRCTs requires a careful balance between minimizing perimeter impingement and enhancing the function of intact muscles, in particular the deltoid and any remaining rotator cuff. Controversy continues regarding the benefits and disadvantages of subscapularis repair at the time of RSA. Tendon and muscle transfers performed at the time of RSA have the potential to optimize the outcome in selected patients with profound weakness in external rotation or those with severe deltoid dysfunction. Summary When RSA is considered for patients with a FIRCT without arthritis, careful attention to indications and technical pearls may contribute to optimize outcomes.

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“…Forty-two articles did not meet the inclusion criteria, leaving 6 articles. 7 , 12 , 17 , 21 , 24 , 31 The flowchart of study selection is shown in Figure 2 .…”

Section: Resultsmentioning

confidence: 99%

Comparison of Lateralized Versus Medialized Reverse Total Shoulder Arthroplasty: A Systematic Review and Meta-analysis

Cho

Aldhafian

Kim

2022

Orthopaedic Journal of Sports Medicine

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Background: Reverse total shoulder arthroplasty (rTSA) is an established procedure for cuff tear arthropathy. More lateralized prostheses have been designed to overcome the reported adverse outcomes of Grammont-style rTSA. Purpose: To compare the clinical and radiological outcomes of medialized and lateralized center of rotation (COR) in rTSA. Study Design: Systematic review; Level of evidence, 3. Methods: This review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Included were studies with a level of evidence ≥3 that compared medialized and lateralized rTSA with a minimum follow-up of 12 months. Functional scores including the American Shoulder and Elbow Surgeons (ASES) score and Constant score (CSS), range of motion at final follow-up, gain of external rotation (ER), visual analog scale (VAS) pain score, scapular notching, and heterotopic ossification (HO) were compared. Data were analyzed using random-effects or fixed-effects models in accordance with heterogeneity. Results: Five retrospective cohort studies and 1 randomized controlled study (n = 594 patients) were included. Lateralized rTSA resulted in greater improvement in ER degree ( P < .001), a lower VAS pain score (standardized mean difference [SMD], –0.39; P = .002), and a lower rate of scapular notching (risk ratio [RR], 0.40; P < .001) and HO (RR, 0.52; P < .001). Final forward flexion (SMD, –0.14; P = .629) and ER (SMD, 0.21; P = .238) did not differ significantly between the 2 groups. Overall functional scores, including ASES score (SMD, 0.22; P = .310) and CSS (SMD, 0.37; P = .077), also did not differ significantly (SMD, 0.28; P = .062). The overall complication rate did not differ significantly between the 2 groups (RR, 0.71; P = .339). Conclusion: Compared with medialized rTSA, lateralized COR rTSA results in greater improvement in ER and the VAS pain score, decreased rates of scapular notching and HO, and no significant changes in functional outcome scores or the complication rate.

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Primary reverse shoulder arthroplasty: how did medialized and glenoid-based lateralized style prostheses compare at 10 years?

Cited by 26 publications

References 16 publications

Results after primary reverse shoulder arthroplasty with and without subscapularis repair: a prospective-randomized trial

Results after primary reverse shoulder arthroplasty with and without subscapularis repair: a prospective-randomized trial

How to Optimize Reverse Shoulder Arthroplasty for Irreparable Cuff Tears

Comparison of Lateralized Versus Medialized Reverse Total Shoulder Arthroplasty: A Systematic Review and Meta-analysis

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