Total shoulder arthroplasty – Arthroplasty for glenohumeral arthropathies: Results and complications after a minimum follow-up of 8years according to the type of arthroplasty and etiology

Abstract

IV - Retrospective study.

Reverse shoulder prosthesis in patients with rheumatoid arthritis: a systematic review

“…However, the survival rate of the implant in the entire group of studies was 90.8 % at a mean of almost five years, which is an encouraging figure, though not so high as to give the patients sound certainty of long-term good results. Our findings support the belief of Favard et al [27] that young patients with RA are better candidates for HA, whereas an RSA can be indicated in older subject as, on the other hand, it is still the rule in the most common indications for RSA.…”

“…In four of such studies the rate of revisions was 4.5 % [34], 7.5 % [28], 12 % [13] and 14.8 % [27]. In this review, infection was the cause of revision in four of eight cases.…”

“…Guery et al [28] stated that extreme caution is needed regarding the use of RSA in patients with RA because they have the highest percentage of implant revisions, which were two, both due to infection, in the eight rheumatoid cases in their series. Similarly, Favard et al [27] found the postoperative Cs and functional improvement to be significantly poorer in cases with RA than in those operated on for other aetiologies. However, of the 18 rheumatoid patients in their series, only six had undergone RSA; the remaining 12 had TSA or HA and the authors do not specify whether the poor results were found in those with RSA or also in the other rheumatoid patients.…”

“…Of the latter, 33 were excluded. In 19 reporting on patients who had undergone RSA or TSA, there were no rheumatoid patients with RSA [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]; nine studies on patients who had had an RSA for various aetiologies included one or more rheumatoid patients, but no or insufficient information was provided on their outcomes [26][27][28][29][30][31][32][33][34]; three review articles on RSA in patients with various conditions gave very little information, contained in a short paragraph [35,36], or limited information [37], for the RA group; there were also two articles of general information on shoulder arthroplasty reporting no own case series [38,39]. Two additional studies reported enough pertinent and useful information on several [40] or many [41] RA patients undergoing RSA, but they were excluded because the mean follow-up was less than 36 months and the longest did not reach five years.…”

Expanding roles for reverse shoulder arthroplasty

“…Glenoid loosening remains the most common indications for TSA revision [68]. In these cases, loosening of the glenoid component also often involves significant glenoid bone loss that may be difficult to reliably reconstruct with a TSA glenoid component.…”