Vincenzo Guarrella1, Mikael Chelli2, Peter Domos3, Francesco Ascione4,5, Pascal Boileau2, Gilles Walch6. 1. Istituto Ortopedico Galeazzi, IRCCS, Milano, Italy. 2. Department of Orthopaedics and Sports Surgery, University Institute of locomotion and Sports, Nice, France. 3. Royal Free London NHS Foundation Trust, London, UK. 4. Department of Shoulder Surgery, Campolongo Hospital, Salerno, Italy. 5. Department of Orthopaedic and Traumatology Surgery, Ospedale Buon Consiglio Fatebenefratelli, Napoli, Italy. 6. Centre Orthopaedique Santy, Hopital Privé Jean Mermoz Ramsay-GDS, Lyon, France.
Abstract
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: 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: 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: 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.
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: 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: 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: 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.
Authors: Jacques Guery; Luc Favard; François Sirveaux; Didier Oudet; Daniel Mole; Gilles Walch Journal: J Bone Joint Surg Am Date: 2006-08 Impact factor: 5.284
Authors: Sergio Gutiérrez; Charles A Comiskey; Zong-Ping Luo; Derek R Pupello; Mark A Frankle Journal: J Bone Joint Surg Am Date: 2008-12 Impact factor: 5.284
Authors: Jason C Clark; Joseph Ritchie; Frederick S Song; Michael J Kissenberth; Stefan J Tolan; Nathan D Hart; Richard J Hawkins Journal: J Shoulder Elbow Surg Date: 2011-07-31 Impact factor: 3.019
Authors: Joo Han Oh; Sang-Jin Shin; Michelle H McGarry; Jonathan H Scott; Nathanael Heckmann; Thay Q Lee Journal: J Shoulder Elbow Surg Date: 2014-01-28 Impact factor: 3.019
Authors: Mark Frankle; Steven Siegal; Derek Pupello; Arif Saleem; Mark Mighell; Matthew Vasey Journal: J Bone Joint Surg Am Date: 2005-08 Impact factor: 5.284
Authors: Bryan Wall; Laurent Nové-Josserand; Daniel P O'Connor; T Bradley Edwards; Gilles Walch Journal: J Bone Joint Surg Am Date: 2007-07 Impact factor: 5.284
Authors: Margaret A Sinkler; Joshua D Dolan; Drew Henderson; Michael J Steflik; Frank D Lewis; Stephen A Parada; Lynn A Crosby Journal: J Orthop Date: 2022-09-29
Authors: Francesco Ascione; Alfredo Schiavone Panni; Adriano Braile; Katia Corona; Giuseppe Toro; Nicola Capuano; Alfonso M Romano Journal: J Orthop Traumatol Date: 2021-07-08