Primary Unconstrained Shoulder Arthroplasty in Patients With a Fixed Anterior Glenohumeral Dislocation

Matsoukis, Jean; Tabib, W; Guiffault, P.; Mandelbaum, A.; Walch, Gilles; NÉMOZ, CHANTAL; Cortés, Zenia E.; Edwards, T. Bradley

doi:10.2106/00004623-200603000-00013

Cited by 8 publications

(14 citation statements)

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“…Although all of the above-mentioned studies showed a significant improvement in the clinical outcome, there was a relatively high rate of patients dissatisfied with their result, complications and revisions when compared with those of unconstrained shoulder replacement for primary osteoarthritis [11,12,15,[24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Reverse arthroplasty for osteoarthritis and rotator cuff deficiency after previous surgery for recurrent anterior shoulder instability

Raiss

Zeifang

Pons-Villanueva

et al. 2014

International Orthopaedics (SICOT)

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Purpose Osteoarthritis in combination with rotator cuff deficiency following previous shoulder stabilisation surgery and after failed surgical treatment for chronic anterior shoulder dislocation is a challenging condition. The aim of this study was to analyse the results of reverse shoulder arthroplasty in such patients. Methods Thirteen patients with a median follow-up of 3.5 (range two to eight) years and a median age of 70 (range 48-82) years were included. In all shoulders a tear of at least one rotator cuff tendon in combination with osteoarthritis was present at the time of arthroplasty. The Constant score, shoulder flexion and external and internal rotation with the elbow at the side were documented pre-operatively and at the final follow-up. Pre-operative, immediate post-operative and final follow-up radiographs were analysed. All complications and revisions were documented. Results Twelve patients were either satisfied or very satisfied with the procedure. The median Constant score increased from 26 points pre-operatively to 67 points at the final follow-up (p=0.001). The median shoulder flexion increased significantly from 70°to 130°and internal rotation from two to four points (p=0.002). External rotation did not change significantly (p=0.55). Glenoid notching was present in five cases and was graded as mild in three cases and moderate in two. One complication occurred leading to revision surgery. Conclusions Reverse arthroplasty leads to high satisfaction rates for patients with osteoarthritis and rotator cuff deficiency who had undergone previous shoulder stabilisation procedures. The improvements in clinical outcome as well as the radiographic results seem to be comparable with those of other studies reporting on the outcome of reverse shoulder arthroplasty for other conditions.

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Section: Discussionmentioning

confidence: 99%

Reverse arthroplasty for osteoarthritis and rotator cuff deficiency after previous surgery for recurrent anterior shoulder instability

Raiss

Zeifang

Pons-Villanueva

et al. 2014

International Orthopaedics (SICOT)

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“…However, fixed anterior glenohumeral dislocation in combination with large humeral defects is a rare condition. The above-mentioned studies [14,21] also presented low numbers with a maximum of 11 [14] patients for anterior dislocation and 12 patients [21] for posterior dislocation treated with shoulder arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

“…As an alternative treatment option, filling of the defect with humeral allograft has been proposed [5,18]. In the treatment of larger defects caused by anterior or posterior dislocation of the humeral head, hemi-or total shoulder arthroplasty has already been described [1,6,14,17,19,21]. Until now, there is no standard procedure for these types of lesions.…”

Section: Discussionmentioning

confidence: 99%

“…Until now, there is no standard procedure for these types of lesions. Matsoukis et al [14] described a series of 11 patients with fixed anterior glenohumeral dislocation treated with hemi-or total shoulder arthroplasty. Seven complications in five shoulders were observed in this series with a mean follow-up of 48 months.…”

Section: Discussionmentioning

confidence: 99%

“…These include reorientation of the humeral head [9,23], filling the defect with humeral allograft [18] to restore joint congruency, and bone transfer techniques [4,7,11,24]. Shoulder replacement for fixed shoulder dislocation has been discussed extensively as new implants were developed in shoulder arthroplasty in recent years [1,14,17,19,21]. Resurfacing arthroplasty is an established bone preserving alternative treatment option for shoulder hemiarthroplasty [12,13] and could be an option for patients with fixed shoulder dislocation in combination with large humeral head defects.…”

Section: Introductionmentioning

confidence: 99%

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Humeral head resurfacing for fixed anterior glenohumeral dislocation

Raiss

Aldinger

Kasten

et al. 2007

International Orthopaedics (SICOT)

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The purpose of this prospective study was to describe cementless humeral surface replacement arthroplasty (CHSRA) as a bone preserving treatment option for patients with fixed anterior glenohumeral dislocation. Ten patients with post-traumatic fixed anterior glenohumeral dislocation underwent CHSRA with a mean follow-up of 24 months. All patients were evaluated clinically using the Constant score and with radiographs in two planes. There were two reoperations: one patient developed glenoid erosion and was revised and in another case redislocation occurred. Clinical or radiographical signs of implant loosening were not found. The humeral head centred in the glenoid in nine out of ten cases radiographically. The Constant score increased from 20 points preoperatively to 61 points postoperatively (p<0.007). CHSRA is a viable treatment option for elderly patients with fixed anterior glenohumeral dislocation and bone defects of the humeral head. Good clinical results and a moderate complication rate were found in the short term.Résumé Le sujet de cette étude prospective était de montrer que le resurfaçage sans ciment au niveau de l'épaule est un option permettant la préservation du capital osseux pour des patients avec une luxation antérieure chronique de l'épaule. Dix patients avec une luxation gléno humérale antérieure fixée ont subi un resurfaçage sans ciment avec un suivi moyen de 24 mois. Tous les patients ont été évalués cliniquement à l'aide du score de Constant et des radiographies dans deux plans. Deux réinterventions ont été nécessaires. Un patient a développé une érosion glénoïdienne nécessitant un changement de prothèse et un patient a récidivé sa luxation. Il n'y avait pas de signe clinique ou radiographique de descellement des implants. La tête humérale était centrée dans la glène dans 9 cas sur 10. Le score de constant s'est accru de 20 points en préopératoire à 61 points en post opératoire (p<0.007). Le resurfaçage huméral sans ciment est donc une solution fiable pour les patients âgés avec une luxation antérieure chronique et une encoche au niveau de la tête humérale. De bons résultats clinique et un taux de complications modéré ont été retrouvés à court terme.

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Prothèses inversées d’épaule pour luxation antérieure invétérée : à propos de 15 cas

Lamy

Sirveaux

Clavert

et al. 2013

Revue de Chirurgie Orthopédique et Traumatologique

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Primary Unconstrained Shoulder Arthroplasty in Patients With a Fixed Anterior Glenohumeral Dislocation

Cited by 8 publications

References 8 publications

Reverse arthroplasty for osteoarthritis and rotator cuff deficiency after previous surgery for recurrent anterior shoulder instability

Reverse arthroplasty for osteoarthritis and rotator cuff deficiency after previous surgery for recurrent anterior shoulder instability

Humeral head resurfacing for fixed anterior glenohumeral dislocation

Prothèses inversées d’épaule pour luxation antérieure invétérée : à propos de 15 cas

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