Reverse shoulder arthroplasty-early results

Abstract

Although reverse shoulder arthroplasty is used in massive rotator cuff tears, it is also used in proximal humerus fractures and shoulder arthroplasty revision. In this study, we aimed to examine the early radiological and clinical results of patients undergoing reverse shoulder arthroplasty with different diagnoses. Between 2010 and 2013, reverse shoulder arthroplasty was applied to 10 patients (4 men, 6 women) with the diagnosis of arthropathy due to rotator cuff tear (n: 7), multi-fragmentary proximal humerus fracture (n: 2) and hemiarthroplasty revision (n: 1). The median age of the patients was 74 (64- 85) years and the median follow-up was 15.5 (3-35) months. Patients were assessed in terms of joint range of motion, Constant score and Visual Pain Scale (VAS) and radiological examinations before and after surgery. Preoperative active shoulder flexion, abduction, internal and external rotation degrees of the patients were 65, 30, 40 and 50 degrees, and 105, 95, 30, 57.5 degrees respectively in their final controls. Constant score was 20.5 (14-63) preoperatively, and 54.5 (38-64) in the final controls (p˂0.05). While the preoperative VAS was 7 (3-9), it was found to be 1.5 (1-3) in the final controls (p˂0.05). As a complication, scapular notching was observed in one patient. Internal- external rotation values were better in the rotator cuff arthropathy group than the fracture group. Reverse shoulder arthroplasty, especially in the treatment of patients with rotator cuff arthropathy, has good early results and a low complication rate. We recommend paying attention to the glenoid component location to avoid scapular notching.

Keywords

• Proximal humerus fracture,Rotator cuff arthropathy,Scapular notching,Reverse shoulder arthroplasty

References

1. Referans1 Baulot, E., Sirveaux, F., Boileau, P., 2011. Grammont's idea: The story of Paul Grammont's functional surgery concept and the development of the reverse principle. Clin Orthop Relat Res. 469, 2425-31.
2. Referans2 Berhouet, J., Garaud, P., Favard, L., 2014. Evaluation of the role of glenosphere design and humeral component retroversion in avoiding scapular notching during reverse shoulder arthroplasty. J Shoulder Elbow Surg. 23, 151-8.
3. Referans3 Boileau, P., Watkinson, D., Hatzidakis, A.M., Hovorka, I., 2006. Neer Award 2005: The Grammont reverse shoulder prosthesis: results in cuff tear arthritis, fracture sequelae, and revision arthroplasty. J Shoulder Elbow Surg. 15, 527-40.
4. Referans4 Boileau, P., Gonzalez, J.F., Chuinard, C., Bicknell, R., Walch, G., 2009. Reverse total shoulder arthroplasty after failed rotator cuff surgery. J Shoulder Elbow Surg. 18, 600-6.
5. Referans5 Boyle, M.J., Youn, S.M., Frampton, C.M., Ball, C.M., 2013. Functional outcomes of reverse shoulder arthroplasty compared with hemiarthroplasty for acute proximal humeral fractures. J Shoulder Elbow Surg. 22, 32-7.
6. Referans6 Cazeneuve, J.F., Cristofari, D.J., 2010. The reverse shoulder prosthesis in the treatment of fractures of the proximal humerus in the elderly. J Bone Joint Surg Br. 92, 535- 9.
7. Referans7 Cheung, E., Willis, M., Walker, M., Clark, R., Frankle, M.A., 2011. Complications in reverse total shoulder arthroplasty. J Am Acad Orthop Surg. 19, 439-49.
8. Referans8 Edwards, T.B., Trappey, G.J., Riley, C., O'Connor, D.P., Elkousy, H.A., Gartsman, G.M., 2012. Inferior tilt of the glenoid component does not decrease scapular notching in reverse shoulder arthroplasty: results of a prospective randomized study. J Shoulder Elbow Surg. 21, 641-6.

9. Referans9 Friedman, R.J., Barcel, D.A., Eichinger, J.K., 2019. Scapular Notching in Reverse Total Shoulder Arthroplasty. J Am Acad Orthop Surg. 27, 200-209.
10. Referans10 Grammont, P.M., Baulot, E., 1993. Delta shoulder prosthesis for rotator cuff rupture. Orthopedics. 16, 65-8.
11. Referans11 Guery, J., Favard, L., Sirveaux, F., Oudet, D., Mole, D., Walch, G., 2006. Reverse total shoulder arthroplasty. Survivorship analysis of eighty replacements followed for five to ten years. J Bone Joint Surg Am. 88, 1742-7.
12. Referans12 Ladermann, A., Lubbeke, A., Collin, P., Edwards, T.B., Sirveaux, F., Walch, G., 2011. Influence of surgical approach on functional outcome in reverse shoulder arthroplasty. Orthop Traumatol Surg Res. 97, 579-82.
13. Referans13 Levigne, C., Boileau, P., Favard, L., Garaud, P., Mole, D., Sirveaux, F., Walch, G., 2008. Scapular notching in reverse shoulder arthroplasty. J Shoulder Elbow Surg. 17, 925-35.
14. Referans14 Levigne, C., Garret, J., Boileau, P., Alami, G., Favard, L., Walch, G., 2011. Scapular notching in reverse shoulder arthroplasty: is it important to avoid it and how? Clin Orthop Relat Res. 469, 2512-20.
15. Referans15 Levy, J.C., Badman, B., 2011. Reverse shoulder prosthesis for acute four-part fracture: tuberosity fixation using a horseshoe graft. J Orthop Trauma. 25, 318-24.
16. Referans16 Matsen, F.A., 3rd, Boileau, P., Walch, G., Gerber, C., Bicknell, R.T., 2007. The reverse total shoulder arthroplasty. J Bone Joint Surg Am. 89, 660-7.
17. Referans17 Melis, B., Bonnevialle, N., Neyton, L., Levigne, C., Favard, L., Walch, G., Boileau, P., 2012. Glenoid loosening and failure in anatomical total shoulder arthroplasty: is revision with a reverse shoulder arthroplasty a reliable option? J Shoulder Elbow Surg. 21, 342-9.
18. Referans18 Mizuno, N., Denard, P.J., Raiss, P., Walch, G., 2012. The clinical and radiographical results of reverse total shoulder arthroplasty with eccentric glenosphere. Int Orthop. 36, 1647-53.
19. Referans19 Mole, D., Wein, F., Dezaly, C., Valenti, P., Sirveaux, F., 2011. Surgical technique: the anterosuperior approach for reverse shoulder arthroplasty. Clin Orthop Relat Res. 469, 2461-8.
20. Referans20 Ramirez, M.A., Ramirez, J., Murthi, A.M., 2012. Reverse total shoulder arthroplasty for irreparable rotator cuff tears and cuff tear arthropathy. Clin Sports Med. 31, 749-59.
21. Referans21 Shafritz, A.B., Flieger, S., 2012. Reverse total shoulder arthroplasty: early results of forty-one cases and a review of the literature. Hand Clin. 28, 469-79.
22. Referans22 Simovitch, R.W., Zumstein, M.A., Lohri, E., Helmy, N., Gerber, C., 2007. Predictors of scapular notching in patients managed with the Delta III reverse total shoulder replacement. J Bone Joint Surg Am. 89, 588-600.
23. Referans23 Sirveaux, F., Favard, L., Oudet, D., Huquet, D., Walch, G., Mole, D., 2004. Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Joint Surg Br. 86, 388-95.
24. Referans24 Vanhove, B., Beugnies, A., 2004. Grammont's reverse shoulder prosthesis for rotator cuff arthropathy. A retrospective study of 32 cases. Acta Orthop Belg. 70, 219-25.
25. Referans25 Wall, B., Nove-Josserand, L., O'Connor, D.P., Edwards, T.B., Walch, G., 2007. Reverse total shoulder arthroplasty: a review of results according to etiology. J Bone Joint Surg Am. 89, 1476-85.
26. Referans26 Werner, C.M., Steinmann, P.A., Gilbart, M., Gerber, C., 2005. Treatment of painful pseudoparesis due to irreparable rotator cuff dysfunction with the Delta III reverse-ball-and-socket total shoulder prosthesis. J Bone Joint Surg Am. 87, 1476- 86.