Jacob L Cox1, Paul B McLendon2, Kaitlyn N Christmas3, Peter Simon4, Mark A Mighell2, Mark A Frankle5. 1. Department of Orthopaedics and Sports Medicine, Morsani College of Medicine, Tampa, FL, USA. 2. Florida Orthopaedic Institute, Tampa, FL, USA. 3. Foundation for Orthopaedic Research & Education, Tampa, FL, USA. 4. Department of Orthopaedics and Sports Medicine, Morsani College of Medicine, Tampa, FL, USA; Foundation for Orthopaedic Research & Education, Tampa, FL, USA. 5. Florida Orthopaedic Institute, Tampa, FL, USA. Electronic address: mfrankle@floridaortho.com.
Abstract
BACKGROUND: Patients with pain and disability due to a prior failed shoulder arthroplasty with associated proximal humeral bone loss have limited reconstruction options. Our purpose was to report the results of a large cohort of patients treated with a reverse shoulder allograft-prosthetic composite (APC). METHODS: Between 2002 and 2012, a total of 73 patients were treated with a reverse shoulder APC and had adequate follow-up. Clinical outcome scores, range of motion, and radiographic evidence of failure were assessed. The minimum follow-up period was 2 years, with an average of 67.9 months (range, 21-157 months). Of the patients, 43 had more than 5 years' follow-up and 12 had more than 10 years' follow-up. RESULTS: The total American Shoulder and Elbow Surgeons score improved from 33.8 to 51.4 (P < .0001), and the Simple Shoulder Test score improved from 1.3 to 3.5 (P < .0001). Good to excellent results were reported in 42 of 60 patients (70%), 10 patients (17%) reported satisfactory results, and 8 patients (13%) were unsatisfied. Range of motion improved in forward flexion (49° to 75°, P < .001) and abduction (45° to 72°, P < .001). Revision was required in 14 patients (19%) for periprosthetic fracture (n = 6), instability (n = 2), glenosphere dissociation (n = 2), humeral loosening (n = 2), and infection (n = 2) at a mean of 38 months postoperatively. The reoperation-free survival rate of all reconstructions was 88% (30 of 34) at 5 years, 78% (21 of 27) at 10 years, and 67% (8 of 12) beyond 10 years. Ten patients had radiographic evidence of humeral loosening at final follow-up, and 2 required revision. CONCLUSIONS: The use of a reverse total shoulder APC provides reliable pain relief and improved range of motion, with an acceptable rate of complications. Although ultimate function achieved is limited, patient satisfaction remains high.
BACKGROUND:Patients with pain and disability due to a prior failed shoulder arthroplasty with associated proximal humeral bone loss have limited reconstruction options. Our purpose was to report the results of a large cohort of patients treated with a reverse shoulder allograft-prosthetic composite (APC). METHODS: Between 2002 and 2012, a total of 73 patients were treated with a reverse shoulder APC and had adequate follow-up. Clinical outcome scores, range of motion, and radiographic evidence of failure were assessed. The minimum follow-up period was 2 years, with an average of 67.9 months (range, 21-157 months). Of the patients, 43 had more than 5 years' follow-up and 12 had more than 10 years' follow-up. RESULTS: The total American Shoulder and Elbow Surgeons score improved from 33.8 to 51.4 (P < .0001), and the Simple Shoulder Test score improved from 1.3 to 3.5 (P < .0001). Good to excellent results were reported in 42 of 60 patients (70%), 10 patients (17%) reported satisfactory results, and 8 patients (13%) were unsatisfied. Range of motion improved in forward flexion (49° to 75°, P < .001) and abduction (45° to 72°, P < .001). Revision was required in 14 patients (19%) for periprosthetic fracture (n = 6), instability (n = 2), glenosphere dissociation (n = 2), humeral loosening (n = 2), and infection (n = 2) at a mean of 38 months postoperatively. The reoperation-free survival rate of all reconstructions was 88% (30 of 34) at 5 years, 78% (21 of 27) at 10 years, and 67% (8 of 12) beyond 10 years. Ten patients had radiographic evidence of humeral loosening at final follow-up, and 2 required revision. CONCLUSIONS: The use of a reverse total shoulder APC provides reliable pain relief and improved range of motion, with an acceptable rate of complications. Although ultimate function achieved is limited, patient satisfaction remains high.
Authors: Marcin Ceynowa; Krzysztof Zerdzicki; Pawel Klosowski; Maciej Zrodowski; Rafal Pankowski; Marek Roclawski; Tomasz Mazurek Journal: PLoS One Date: 2021-02-11 Impact factor: 3.240
Authors: Sarav S Shah; Alexander M Roche; Spencer W Sullivan; Benjamin T Gaal; Stewart Dalton; Arjun Sharma; Joseph J King; Brian M Grawe; Surena Namdari; Macy Lawler; Joshua Helmkamp; Grant E Garrigues; Thomas W Wright; Bradley S Schoch; Kyle Flik; Randall J Otto; Richard Jones; Andrew Jawa; Peter McCann; Joseph Abboud; Gabe Horneff; Glen Ross; Richard Friedman; Eric T Ricchetti; Douglas Boardman; Robert Z Tashjian; Lawrence V Gulotta Journal: JSES Int Date: 2020-09-10