Reverse shoulder prosthesis as revision surgery after fractures of the proximal humerus, treated initially by internal fixation or hemiarthroplasty

Lollino, Nicola; Paladini, Paolo; Campi, Fabrizio; Merolla, Giovanni; Rossi, P; Porcellini, Giuseppe

doi:10.1007/s12306-009-0006-6

Cited by 10 publications

(16 citation statements)

References 17 publications

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“…We had used it in a previous study [15], and we confirm the reliability of this method, which is very accurate, due to the large amount of ''questions'' included.…”

Section: Discussionsupporting

confidence: 53%

Gleno-Humeral arthritis in young patients: clinical and radiographic analysis of humerus resurfacing prosthesis and meniscus interposition

et al. 2011

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Recently, interest about glenoid resurfacing with lateral meniscus in osteoarthritis of the shoulder has been increasing. Aim of this study is to evaluate the results of this procedure, from a clinical and a radiographic point of view. Constant score, DASH (Disability of the Arm, Shoulder, and Elbow) questionnaire, some specific questions about satisfaction after surgery, and radiographic exams were performed pre-operatively and post-operatively, at a minimum follow-up of 2 years. Constant score improved from 49.8 to 66.2. 84.4% of the patients were satisfied. Mean Dash was about 24.2 points. Gleno-Humeral measurement on X-Ray shows a good widening of the articular space after surgery (5.92 mm), but a narrowing (2.07 mm), at 2 years of follow-up. We have suspended glenoid resurfacing because narrowing of the articular space at follow-up can be related to meniscal resorption and clinical results are good but comparable with humeral resurfacing alone, as seen in the literature. Long-term follow-up studies are needed.

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“…We had used it in a previous study [15], and we confirm the reliability of this method, which is very accurate, due to the large amount of ''questions'' included.…”

Section: Discussionsupporting

confidence: 53%

Gleno-Humeral arthritis in young patients: clinical and radiographic analysis of humerus resurfacing prosthesis and meniscus interposition

et al. 2011

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“…5,17,22,[71][72][73][74][75][76] Revision was performed for failed treatment of proximal humeral fractures in patients with severe pain and loss of function. All patients treated in this way also had one or more of the following: tuberosity reabsorption, radiolucency around the humeral stem, osteoarthritis of the glenoid or a rotator cuff tear of > 2 cm.…”

Section: Revision Surgerymentioning

confidence: 99%

“…All patients treated in this way also had one or more of the following: tuberosity reabsorption, radiolucency around the humeral stem, osteoarthritis of the glenoid or a rotator cuff tear of > 2 cm. 17,71,74 In addition deep shoulder infection following surgery was described with either with a single-stage revision for infected RSR 76 or a single-or two-stage revision following infected hemiarthroplasty or rotator cuff surgery. 72 Further RSR was described after cuff failure following a total or hemiarthroplasty 5,22 and revision RSR after baseplate failure when 79% of patients (11 of 14) were managed by insertion of a larger glenosphere.…”

Section: Revision Surgerymentioning

confidence: 99%

Indications for reverse shoulder replacement

Smith

Guyver

Bunker

2012

The Journal of Bone and Joint Surgery. British volume

125

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The outcome of an anatomical shoulder replacement depends on an intact rotator cuff. In 1981 Grammont designed a novel large-head reverse shoulder replacement for patients with cuff deficiency. Such has been the success of this replacement that it has led to a rapid expansion of the indications. We performed a systematic review of the literature to evaluate the functional outcome of each indication for the reverse shoulder replacement. Secondary outcome measures of range of movement, pain scores and complication rates are also presented.The modern reverse shoulder replacement (RSR) can offer a surgical option for the management of arthritis of the shoulder that would be precluded by a conventional design. 1,2The success of the prosthesis has led to expansion of the indications from cuff tear arthropathy to any disease about the shoulder where cuff function is deficient. 3-5The prosthesis has also been a financial success, leading many companies to introduce their own version with small changes to the original design, such as the Aequalis Reversed Shoulder (Tornier, SaintIsmier, France) and the SMR Shoulder (Lima, Udine, Italy). As a result of the expansion of the indications for RSR, the procedure now accounts for over a large proportion of all shoulder replacements performed in mainland Europe.This article will look at the benefits and risks of RSR for each indication. The original indication for RSR was cuff tear arthropathy. The results obtained for new indications were compared with those for cuff tear arthropathy, with a primary outcome measure as a functional score. Secondary outcome measures were range of movement, rate of complications and pain scores. In order to allow for comparison between groups, the outcome scores, complication rates and pain scores have been converted to percentages.A systematic review of the English-language literature was undertaken; the keywords used were shoulder and reverse; arthroplasty; inverse or delta. Medline, were all searched. Inclusion criteria included studies presenting new data from more than one case and where functional outcome scores were reported. Exclusion criteria included studies that had a mixture of surgical techniques presented as a single group. Further exclusion criteria for the cuff tear arthropathy group were studies published more than five years ago; studies with less than 50 patients and those from more than one centre.We identified 22 papers, which were reviewed in full. The complications of RSR for any indication were discussed and specific issues for each pathology highlighted.All the abstracts were reviewed independently by two of the authors (CDS, PG) to identify studies for full review and the bibliographies of these articles were also reviewed for additional studies. Any disagreements with regards to inclusion and exclusion were resolved by discussion with the senior author (TDB). Cuff tear arthropathyThe modern concept of cuff tear arthropathy is the combination of arthritis and a massive cuff tear where the shoulder joint may remain concent...

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“…Lollino et al investigated similar outcomes in patients who underwent RTSA for revision of failed shoulder hemiarthroplasty or ORIF following three-and four-part proximal humerus fractures [33]. Utilizing validated outcomes and functional testing, the authors found that while clinical outcomes were notably better following ORIF, there were significant improvements in both groups and the overall outcomes were not influenced by the initial method of surgical treatment.…”

Section: Failed Shoulder Hemiarthroplastymentioning

confidence: 99%

Management of proximal humerus fractures utilizing reverse total shoulder arthroplasty

Jones

Dines

Gulotta

et al. 2013

Curr Rev Musculoskelet Med

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The increased incidence of proximal humerus fractures has resulted in a thoughtful evolution of treatment options in order to optimize clinical outcomes. Complex three-and four-part fractures present a treatment challenge, particularly in elderly patients with significant medial comorbidities and poor bone quality. While open reduction and internal fixation is a reasonable surgical option in some patients with acceptable bone quality and simple fracture patterns that are not susceptible to avascular necrosis, shoulder hemiarthroplasty is a well-established procedure for many elderly patients (i.e., >70 years). Historically, hemiarthroplasty has provided reliable pain relief, but outcomes with regard to function, motion, and strength have varied.Ultimately, successful outcomes are dependent upon tuberosity healing, since an intact rotator cuff is required to restore function. With the advent of reverse total shoulder arthroplasty (RTSA) and increased familiarity with the surgical technique, successful outcomes have been achieved in older patients with poor potential for tuberosity healing. In this review, we discuss the recent role of RTSA in the setting of proximal humerus fractures, including surgical indications, preferred operative technique, and recent literature that supports its use.

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Reverse shoulder prosthesis as revision surgery after fractures of the proximal humerus, treated initially by internal fixation or hemiarthroplasty

Cited by 10 publications

References 17 publications

Gleno-Humeral arthritis in young patients: clinical and radiographic analysis of humerus resurfacing prosthesis and meniscus interposition

Gleno-Humeral arthritis in young patients: clinical and radiographic analysis of humerus resurfacing prosthesis and meniscus interposition

Indications for reverse shoulder replacement

Management of proximal humerus fractures utilizing reverse total shoulder arthroplasty

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