Short-term results after reversed shoulder arthroplasty (Delta III) in patients with rheumatoid arthritis and irreparable rotator cuff tear

The aim of this study was to analyse the complication rates of six different shoulder arthroplasty concepts for different diagnoses in the short and midterm. The study included 485 primary shoulder arthroplasties. The mean follow-up of the cohort was 3.5 (1-10) years. Complications were classified into three categories: (1) without reoperation, (2) soft tissue revision and (3) implant revision. In total, 56 complications were recorded (11.6%): 34 (7%) were category 1 complications, 11 (2.3%) were category 2 and 11 (2.3%) were category 3. For the whole cohort the median follow-up was 1.6 years (1-10 years) and the survival rate without any complication was 90.5% (95% CI: 87.9-93.1). Patients rated the result of their surgery in 270 (55.7%) cases as very satisfied, in 148 (30.5%) as satisfied, in 43 (8.9%) as somewhat disappointed and in 24 (4.9%) as disappointed. A relatively low complication rate was found in this study. Longterm observations are necessary to confirm these results.

Section: Discussionmentioning

confidence: 99%

Complications in shoulder arthroplasty: an analysis of 485 cases

Aldinger

Raiss

Rickert

et al. 2009

“…Even if satisfactory results have been achieved in treatment of cuff tear arthropathy with RSA [40][41][42] limited information is available in its use for revision surgery.…”

Section: Discussionmentioning

confidence: 99%

Conversion of shoulder arthroplasty to reverse implants: clinical and radiological results using a modular system

Castagna

Delcogliano

et al. 2013

Purpose Revision of a shoulder arthroplasty to a reverse arthroplasty is a highly demanding procedure. The aim of this study is to report the clinical results of hemi and total shoulder prosthesis revisions to reverse implants without removal of the humeral stem, using a modular shoulder replacement system (SMR Lima LTD). We retrospectively reviewed 26 patients who underwent an operation from 2004 to 2009. Methods The patients were divided into two groups: in Group I, 18 patients underwent a revision of hemiarthroplasty implanted for fracture; in Group II, eight patients underwent a revision of anatomical total prosthesis. All patients were evaluated at a mean follow-up of 32.3 (±12.7) months using the Constant score rating scale and by range of motion evaluation, EQ-VAS, X-ray and CT scan. Results The Constant score of each patient was 47.88 (±5.88) after the revision. The EQ-VAS improved from 40 (±20) to 70 (±10). All patients improved in terms of range of motion.The radiographs and CT scans obtained after revision showed good integration and no signs of loosening of the implant. The mean time of surgery was recorded as 62′ (±8′), with a maximum blood loss of less than 300 ml in all cases. Conclusions Our study demonstrates that using a full modular system at the time of the first implant allows avoidance of the step to remove the humeral stem and metal back in cases of shoulder prosthesis revision to a reverse prosthesis, resulting in a short operative time, few intraoperative complications and a satisfactory clinical outcome at medium-term follow-up.

“…Among RA patients in our study, RTPs were used much more frequently than TPs, and RTPs performed very well in this patient group. Good functional results and pain relief have previously been demonstrated for RTPs and in patients with RA [21][22][23][24], although no comparison of RTPs to HPs has previously been published. The frequent incidence of damaged rotator cuff in RA patients suggests the use of RTPs rather than TPs; randomised studies are needed to further investigate this.…”

Section: Conventional and Reverse Total Shoulder Arthroplastymentioning

confidence: 99%

Pain and function in eight hundred and fifty nine patients comparing shoulder hemiprostheses, resurfacing prostheses, reversed total and conventional total prostheses

Fevang

Lygre

Bertelsen

et al. 2012

Purpose Functional results of reversed total prostheses (RTP) have-to a very limited degree-been compared with those of other shoulder prosthesis types. The aim of our study was to compare results of four different types of shoulder prostheses in terms of function, pain, and quality of life (QoL). Methods Questionnaires were completed by 859 patients with shoulder prostheses registered in the Norwegian Arthroplasty Register. Patients with osteoarthritis (OA), rheumatoid arthritis (RA), or fracture sequela (FS) were included. Symptoms and function were assessed using the Oxford Shoulder Score (OSS, scale 0-48), and the EuroQoL-5D (EQ-5D) was used to assess QoL. Results Best functional results were obtained using conventional total prostheses (TPs) and RTPs -mean OSS improvement 18 and 16 units, respectively, vs 11 with hemiprostheses (HPs). For patients with OA, TPs performed best; for those with RA and FS, RTPs performed best; and those with HPs had the worst results in all diagnostic groups. The greatest improvement in QoL was seen in patients with TPs and RTPs. Conclusions Conventional TPs provide the best improvement in pain, function and QoL in OA patients; RTPs are superior in patients with RA and FS.