Risk factors for instability after reverse shoulder arthroplasty.
BIO-RSA
deltoid tensioning
dislocation
humeral lengthening
prosthetic instability
reverse shoulder arthroplasty complication
Journal
Shoulder & elbow
ISSN: 1758-5732
Titre abrégé: Shoulder Elbow
Pays: United States
ID NLM: 101506589
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
01
02
2019
revised:
03
06
2019
accepted:
04
06
2019
entrez:
15
3
2021
pubmed:
16
3
2021
medline:
16
3
2021
Statut:
ppublish
Résumé
This study aims to identify risk factors related to postoperative instability after reverse shoulder arthroplasty and evaluate the modalities and results of treatments in a large series of patients, with medium to long-term follow-up. Retrospective multicenter series of 1035 consecutive Grammont type reverse shoulder arthroplasties implanted between 1992 and 2010. 19.9% had a reverse shoulder arthroplasty with bony lateralization on the glenoid side. Patients were reviewed and radiographed with minimum five years' follow-up. At a mean follow-up of eight years, the overall rate of postoperative instability was 3.0%. Instability was more frequent in case of reverse shoulder arthroplasty for revision surgery, in younger patients, in case of scapular notching, and tuberosity resorption. Lateralized reverse shoulder arthroplasties were associated with a lower instability rate. A reoperation to restore stability was needed in 70% of cases. The improvement in Constant Score was lower in patients with unstable reverse shoulder arthroplasties when compared to stable reverse shoulder arthroplasties. Younger patients are at higher risk for instability after Grammont type reverse shoulder arthroplasty implantation. Conversely, lateralized reverse shoulder arthroplasties resulted protective. When conservative treatment had failed, shoulder stability can be obtained with reoperation or prosthetic revision (needed in 70% of the cases), but to the price of lower functional results.
Sections du résumé
BACKGROUND
BACKGROUND
This study aims to identify risk factors related to postoperative instability after reverse shoulder arthroplasty and evaluate the modalities and results of treatments in a large series of patients, with medium to long-term follow-up.
METHODS
METHODS
Retrospective multicenter series of 1035 consecutive Grammont type reverse shoulder arthroplasties implanted between 1992 and 2010. 19.9% had a reverse shoulder arthroplasty with bony lateralization on the glenoid side. Patients were reviewed and radiographed with minimum five years' follow-up.
RESULTS
RESULTS
At a mean follow-up of eight years, the overall rate of postoperative instability was 3.0%. Instability was more frequent in case of reverse shoulder arthroplasty for revision surgery, in younger patients, in case of scapular notching, and tuberosity resorption. Lateralized reverse shoulder arthroplasties were associated with a lower instability rate. A reoperation to restore stability was needed in 70% of cases. The improvement in Constant Score was lower in patients with unstable reverse shoulder arthroplasties when compared to stable reverse shoulder arthroplasties.
CONCLUSIONS
CONCLUSIONS
Younger patients are at higher risk for instability after Grammont type reverse shoulder arthroplasty implantation. Conversely, lateralized reverse shoulder arthroplasties resulted protective. When conservative treatment had failed, shoulder stability can be obtained with reoperation or prosthetic revision (needed in 70% of the cases), but to the price of lower functional results.
Identifiants
pubmed: 33717218
doi: 10.1177/1758573219864266
pii: 10.1177_1758573219864266
pmc: PMC7905521
doi:
Types de publication
Journal Article
Langues
eng
Pagination
51-57Informations de copyright
© 2019 The British Elbow & Shoulder Society.
Déclaration de conflit d'intérêts
Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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