Reversed shoulder arthroplasty with inversed bearing materials: 2-year clinical and radiographic results in 101 patients

Abstract

IntroductionThis study documents 2-year clinical and radiographic results following reversed total shoulder arthroplasty using a novel prosthesis with inverted bearing materials (polyethylene glenoid; metal humeral component). This design was intended to avoid massive PE abrasion on the humeral side. Therefore, we predicted a lack of subsequent osteolysis-induced exacerbation of scapular notching, and because of other design features and modified operating technique a reduced notching rate.Materials and methodsAn ongoing, prospective, international, multicenter study of patients implanted with a novel prosthesis at six European centers. The current analysis presents 2-year follow-up data (patients operated between December 2007 and July 2009). Clinical evaluation tools comprised the Constant–Murley score (CS), the American Shoulder and Elbow Surgeon score, range of motion, and a visual analog scale to assess pain and satisfaction. Radiographs were evaluated for notching and radiolucent lines. Any complications were recorded.ResultsIn total, 113 prostheses (113 patients) with a mean follow-up of 27.6 (±3.6) months were analyzed. CS increased from 22.5 (±13.7) to 65.3 (±14.9) points (p = 0.06). Inferior scapular notching (only grade 1 and 2) was identified in 20.5 % of patients, with no signs of PE-induced osteolysis. 4.4 % of patients experienced an implant-related complication.ConclusionsInversion of the materials led to another type of notching with no signs of PE-induced osteolysis and no increase in the risk of short-term complications. Clinical results were comparable with other prostheses. Mid- to long-term results are required before any firm conclusions on clinical outcome and survival can be drawn.

A Critical Review on Prosthetic Features Available for Reversed Total Shoulder Arthroplasty

“…Both materials show similar wear, so they are equally valid options [53–55]. A polyethylene glenosphere combined with a metal humeral inlay has the advantage that it creates less polyethylene debris when scapular notching would occur.…”

Treatment Effects of Reverse Total Shoulder Arthroplasty for Unilateral Cuff Tear Arthropathy – Outcomes at 6, 12, 24 and 60 Months and Confounders

“…The primary aim of this study was to measure the TE's for RSA 6,12, [20] who agreed to the informed consent approved by the local ethical committee. Excluded were the patients with trauma/fracture, secondary osteoarthritis, no informed consent, with rheumatoid arthritis, neoplasia, with incomplete data and who had a revision (change of basic parts of the implants) in the first two years.…”

Treatment Effects of Reverse Total Shoulder Arthroplasty – A Simple Method to Measure Outcomes at 6, 12, 24 and 60 Months for Each Patient

“…The type of prosthesis used in this study (A nis® inverse, Fa Mathys, Bettlach, Switzerland) was developed and introduced to the market in 2007. It has been clinically and radiographically tested [12] and can be followed in the implant registries of the Netherlands, UK, AUS and NZ. The outcomes of RSA is promising and the good mid-term results are documented in different studies [6,7,[13][14][15][16].…”