Intermediate to long term results of stemless metaphyseal reverse shoulder arthroplasty: A five to nine year follow-up.
Clinical outcomes
Reverse shoulder arthroplasty
Stemless
Survivorship
Verso
Journal
Journal of clinical orthopaedics and trauma
ISSN: 0976-5662
Titre abrégé: J Clin Orthop Trauma
Pays: India
ID NLM: 101559469
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
30
06
2021
revised:
19
09
2021
accepted:
22
09
2021
entrez:
25
10
2021
pubmed:
26
10
2021
medline:
26
10
2021
Statut:
epublish
Résumé
Shoulder arthroplasty incidence is increasing as is the volume of revision surgeries. Revision surgery is easier if humeral bone stock is preserved with minimal bone defects and osteolysis. This has led to an increased focus on the development of various short stemmed and stemless implants which provides stable fixation whilst preserving humeral bone stock. To review the medium to long term clinical and radiological outcomes, complications and survival rates of a stemless reverse shoulder prosthesis. Patients with a minimum follow-up of 60 months following a reverse stemless shoulder arthroplasty were deemed eligible. Clinical and radiological data on twenty-one patients operated between 2009 and 2014 were recorded prospectively. Survivorship and patient recorded symptoms with the end point of revision surgery were recorded. Mean follow-up of 78 months (60-114 months). Mean range of active elevation was 136° (80-170°). Mean range of active abduction and active external rotation was 122° (70-170°) and 47° (10-75°) respectively. Mean Oxford score improved from 12 pre-operatively to 44 at final follow up (p < 0.0001). Mean Constant Murley Score improved from 18 to 72 (p < 0.0001). Mean ADLEIR score of 13 pre-operatively increased to 32 post-operatively (p < 0.0001). Notching was seen in 23.5% of cases and no radiolucent areas were observed around the glenoid component. There were two cases of post traumatic peri-prosthetic fractures that were managed conservatively and one case of deep-seated infection that required a washout. The survivorship at the most recent follow-up was 100%. The advantages of bone preservation with the stemless metaphyseal prosthesis combined with encouraging medium to long term clinical and radiological results are very promising, particularly with the improved post-operative patient satisfaction scores. This is the first study that reports the results with a minimum of 5 year follow-up and has the longest mean follow-up period. The reverse stemless shoulder prosthesis is an effective and reliable option for elective shoulder arthroplasty.
Sections du résumé
BACKGROUND
BACKGROUND
Shoulder arthroplasty incidence is increasing as is the volume of revision surgeries. Revision surgery is easier if humeral bone stock is preserved with minimal bone defects and osteolysis. This has led to an increased focus on the development of various short stemmed and stemless implants which provides stable fixation whilst preserving humeral bone stock.
PURPOSE
OBJECTIVE
To review the medium to long term clinical and radiological outcomes, complications and survival rates of a stemless reverse shoulder prosthesis.
PATIENTS AND METHOD
METHODS
Patients with a minimum follow-up of 60 months following a reverse stemless shoulder arthroplasty were deemed eligible. Clinical and radiological data on twenty-one patients operated between 2009 and 2014 were recorded prospectively. Survivorship and patient recorded symptoms with the end point of revision surgery were recorded.
RESULTS
RESULTS
Mean follow-up of 78 months (60-114 months). Mean range of active elevation was 136° (80-170°). Mean range of active abduction and active external rotation was 122° (70-170°) and 47° (10-75°) respectively. Mean Oxford score improved from 12 pre-operatively to 44 at final follow up (p < 0.0001). Mean Constant Murley Score improved from 18 to 72 (p < 0.0001). Mean ADLEIR score of 13 pre-operatively increased to 32 post-operatively (p < 0.0001). Notching was seen in 23.5% of cases and no radiolucent areas were observed around the glenoid component. There were two cases of post traumatic peri-prosthetic fractures that were managed conservatively and one case of deep-seated infection that required a washout. The survivorship at the most recent follow-up was 100%.
CONCLUSION
CONCLUSIONS
The advantages of bone preservation with the stemless metaphyseal prosthesis combined with encouraging medium to long term clinical and radiological results are very promising, particularly with the improved post-operative patient satisfaction scores. This is the first study that reports the results with a minimum of 5 year follow-up and has the longest mean follow-up period.
CLINICAL RELEVANCE
CONCLUSIONS
The reverse stemless shoulder prosthesis is an effective and reliable option for elective shoulder arthroplasty.
Identifiants
pubmed: 34692406
doi: 10.1016/j.jcot.2021.101611
pii: S0976-5662(21)00495-1
pmc: PMC8517546
doi:
Types de publication
Journal Article
Langues
eng
Pagination
101611Informations de copyright
Crown Copyright © 2021 All rights reserved.
Déclaration de conflit d'intérêts
The authors do not have any conflict of interest to disclose.
Références
Oper Orthop Traumatol. 2007 Jun;19(2):185-208
pubmed: 17530198
JBJS Rev. 2019 May;7(5):e7
pubmed: 31145263
J Bone Joint Surg Br. 2004 Apr;86(3):388-95
pubmed: 15125127
Int Orthop. 2015 Oct;39(10):1965-9
pubmed: 26318881
J Shoulder Elbow Surg. 2018 Sep;27(9):1596-1601
pubmed: 29779980
Orthop Traumatol Surg Res. 2016 Feb;102(1 Suppl):S33-43
pubmed: 26879334
BMC Musculoskelet Disord. 2018 Jul 21;19(1):245
pubmed: 30031390
J Bone Joint Surg Br. 2001 Mar;83(2):213-21
pubmed: 11284568
Acta Biomed. 2019 Jan 10;90(1-S):47-53
pubmed: 30714998
Clin Orthop Relat Res. 2015 Oct;473(10):3228-34
pubmed: 26162412
Eur J Orthop Surg Traumatol. 2020 Jan;30(1):89-96
pubmed: 31432259
Clin Orthop Relat Res. 2011 Sep;469(9):2512-20
pubmed: 21116754
Proc Inst Mech Eng H. 2009 Oct;223(7):805-12
pubmed: 19908419
J Shoulder Elbow Surg. 2008 Nov-Dec;17(6):925-35
pubmed: 18558499
Int Orthop. 2014 Jun;38(6):1213-8
pubmed: 24705690
Acta Orthop. 2019 Oct;90(5):489-494
pubmed: 31240980
Clin Orthop Relat Res. 2020 May;478(5):1089-1097
pubmed: 31899740
Acta Biomed. 2019 Dec 05;90(12-S):8-13
pubmed: 31821278
J Bone Joint Surg Br. 2011 Sep;93(9):1240-6
pubmed: 21911536
J Shoulder Elbow Surg. 2019 Feb;28(2):e49-e56
pubmed: 30503332
Clin Orthop Relat Res. 1987 Jan;(214):160-4
pubmed: 3791738
J Bone Joint Surg Br. 2007 Feb;89(2):189-95
pubmed: 17322433
J Shoulder Elbow Surg. 2018 Dec;27(12):2145-2152
pubmed: 30093234
J Shoulder Elbow Surg. 2001 Jan-Feb;10(1):17-22
pubmed: 11182731
J Shoulder Elbow Surg. 2011 Jan;20(1):146-57
pubmed: 21134666
Clin Orthop Relat Res. 2019 Feb;477(2):432-441
pubmed: 30601321
Clin Orthop Relat Res. 2011 Sep;469(9):2461-8
pubmed: 21448776
J Shoulder Elbow Surg. 2018 Nov;27(11):1978-1986
pubmed: 29759905