Short-term safety, function, and quality of life in patients treated with Univers Revers prosthesis: a multicenter 2-year follow-up case series

Schwyzer, Hans‐Kaspar; Marzel, Alex; Wirth, Barbara; Rickenbacher, Dominik; Flury, Manuel; Schoch, Christian; Tauber, Mark; Rzepka, Daniel; Lehmann, Lars; Lichtenberg, Sven; Magosch, Petra; Habermeyer, Peter; Audigé, Laurent

doi:10.1016/j.jse.2020.01.090

Cited by 5 publications

(5 citation statements)

References 31 publications

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“…Similarly, our data demonstrated an overall complication rate of 11.5% with a surgical revision rate of 8.2%. These findings are also consistent with general complication rates following RTSA, which have been shown to occur in 10 to 25% of cases [3,4,24].…”

Section: Discussionsupporting

confidence: 88%

“…In the present study the rate of scapular notching (49.2%) was higher compared to results reported by Schwyzer et al (10.6%) [24]. This may be explained by their shorter minimum follow-up of 23 months, as Lévigne et al [21] and Ernstbrunner et al [14] described a progressiveness in frequency of scapular notching over a longer period of time.…”

Section: Discussioncontrasting

confidence: 63%

“…Although this implant is widely used, clinical and radiographic outcomes are limited. Recently, a multicenter case series reported sufficient postoperative improvement in shoulder function and quality of life with the Universe Reverse shoulder prosthesis [24]. The overall complication rate was 25% with only 2.7% considered to be severe.…”

Section: Discussionmentioning

confidence: 99%

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Influence of sportive activity on functional and radiographic outcomes following reverse total shoulder arthroplasty: a comparative study

Geyer

Siebler

Eggers

et al. 2022

Arch Orthop Trauma Surg

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Background The purpose of the present study was to compare the functional and radiographic outcomes following reverse total shoulder arthroplasty (RTSA) in a senior athletic and non-athletic population. Material and methods In this retrospective cohort study, patients who underwent RTSA between 06/2013 and 04/2018 at a single institution were included. Minimum follow-up was 2 years. A standardized questionnaire was utilized for assessment of patients’ pre- and postoperative physical fitness and sportive activity. Patients who resumed at least one sport were assigned to the athletic group, while patients who ceased participating in sports were assigned to the non-athletic group. Postoperative clinical outcome measures included the Constant score (CS), American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test (SST), and visual analog scale (VAS) for pain. Active shoulder range of motion (ROM) and abduction strength were assessed. Radiographic evaluation was based on a standardized core set of parameters for radiographic monitoring of patients following shoulder arthroplasty. Results Sixty-one of 71 patients (85.9%; mean age: 72.1 ± 6.6 years) were available for clinical and radiographic follow-up at a mean of 47.1 ± 18.1 months. Thirty-four patients (55.7%) were assigned to the athletic group and 27 patients (44.3%) to the non-athletic group. The athletic group demonstrated significantly better results for CS (P = 0.002), ASES score (P = 0.001), SST (P = 0.001), VAS (P = 0.022), active external rotation (P = 0.045) and abduction strength (P = 0.016) compared to the non-athletic group. The overall rate of return to sport was 78.0% at an average of 5.3 ± 3.6 months postoperatively. Incomplete radiolucent lines (RLL) around the humeral component were found significantly more frequently in the athletic group compared to the non-athletic group (P = 0.019), whereas the occurrence of complete RLLs around the implant components was similar (P = 0.382). Scapular notching was observed in 18 patients (52.9%) of the athletic group and 12 patients (44.9%) of the non-athletic group (P = 0.51). The overall rate for revision surgery was 8.2%, while postoperative complications were encountered in 3.3% of cases. Conclusion At mid-term follow-up, the athletic population demonstrated significantly better clinical results following RTSA without a higher rate of implant loosening and scapular notching when compared to non-athletic patients. However, incomplete radiolucency around the humeral component was observed significantly more often in the athletic group. Level of evidence III.

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Section: Discussionsupporting

confidence: 88%

Section: Discussioncontrasting

confidence: 63%

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Influence of sportive activity on functional and radiographic outcomes following reverse total shoulder arthroplasty: a comparative study

Geyer

Siebler

Eggers

et al. 2022

Arch Orthop Trauma Surg

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“…19 patients received a prosthesis with a 155° humeral neck-shaft angle and a 10° retroversion (Delta XTend Reverse; DePuy Synthese, Warsaw, Indiana, USA). Since June 2016, the Arthrex Universe Reverse prosthesis with a 135° humeral neck-shaft angle, 30° retroversion, and a + 4 mm Offset (Arthrex Universe Revers, Arthrex; Naples, Florida, USA) [ 20 ] was used in the 22 following patients.…”

Section: Methodsmentioning

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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“…36 Furthermore, recently, the registry played a pivotal role in an international collaboration that determined the shortterm safety of the Univers Revers prosthesis. 37 Patients undergoing RSA often maintain a deficit in external rotation which can limit activities of daily living. It was previously suggested that complementing the RSA with Latissimus dorsi muscle transfer can improve this external rotation deficit.…”

Section: Dropouts Data Completeness and Revision Ratesmentioning

confidence: 99%

The Schulthess local Shoulder Arthroplasty Registry (SAR): cohort profile

et al. 2020

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PurposeClinical registries are essential for evaluation of surgical outcomes. The Schulthess Shoulder Arthroplasty Registry (SAR) was established in 2006 to evaluate safety, function, quality-of-life and patient satisfaction in patients undergoing shoulder arthroplasty.ParticipantsAdult patients undergoing anatomic or reverse shoulder joint replacement at the Schulthess Klinik, a high-volume, leading orthopaedic surgery centre in Zürich, Switzerland.Findings to dateBetween March 2006 and December 2019, the registry covered 98% of eligible operations. Overall, 2332 patients were enrolled with a total of 2796 operations and 11 147 person-years of follow-up. Mean age at baseline was 71 (range: 20–95), 65% were women. Most common indication was rotator cuff tears with osteoarthritis (42%) and the mean preoperative Constant Score was 31 (±15). The most frequent arthroplasty type was reverse, increasing from 61% in 2006–2010 to 86% in 2015–2019. Functional recovery peaked at 12-month postoperatively and did not show a clinically relevant deterioration during the first ten follow-up years. Since its establishment, the registry was used to address multiple pertinent clinical and methodological questions. Primary focus was on comparing different implant configurations (eg, glenosphere diameter) and surgical techniques (eg, latissimus dorsi transfer) to maximise functional recovery. Additionally, the cohort contributed to the determination of the clinical relevance and validity of radiological monitoring of cortical bone resorption and scapular notching. Finally, SAR data helped to demonstrate that returning to sports was among key patient expectations after reverse shoulder arthroplasty.Future plansAs first patients are approaching the 15 years follow-up landmark, the registry will continue providing essential data on long-term functional outcomes, implant stability, revision rates and aetiologies as well as patient satisfaction and quality-of-life. In addition to research and quality-control, the cohort data will be brought back to the patients by bolstering real-time clinical decision support.

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Short-term safety, function, and quality of life in patients treated with Univers Revers prosthesis: a multicenter 2-year follow-up case series

Cited by 5 publications

References 31 publications

Influence of sportive activity on functional and radiographic outcomes following reverse total shoulder arthroplasty: a comparative study

Influence of sportive activity on functional and radiographic outcomes following reverse total shoulder arthroplasty: a comparative study

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

The Schulthess local Shoulder Arthroplasty Registry (SAR): cohort profile

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