Heterotopic ossification of the long head of the triceps after reverse total shoulder arthroplasty

2016 ◽  
Vol 25 (11) ◽  
pp. 1810-1815 ◽  
Author(s):  
Jia-Wei Kevin Ko ◽  
Jeffrey D. Tompson ◽  
Daniel S. Sholder ◽  
Eric M. Black ◽  
Joseph A. Abboud
Keyword(s):  
Heterotopic Ossification ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Long Head ◽  
Reverse Total Shoulder

Reassessing glenoid inclination in reverse total shoulder arthroplasty with glenosphere lateralization

2021 ◽  
Vol 103-B (2) ◽  
pp. 360-365
Author(s):  
Kuhan A. Mahendraraj ◽  
Maggie V. Shields ◽  
Florian Grubhofer ◽  
Samuel W. Golenbock ◽  
Andrew Jawa
Keyword(s):  
Heterotopic Ossification ◽  
Shoulder Arthroplasty ◽  
Patient Reported Outcomes ◽  
External Rotation ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Scapular Notching ◽  
Patient Reported ◽  
Reverse Total Shoulder

Aims Existing literature indicates that inferiorly inclined glenoid baseplates following reverse total shoulder arthroplasty (RSA) produce better outcomes compared to superiorly inclined baseplates. We aim to compare clinical outcomes for RSAs with superiorly and neutrally/inferiorly inclined lateralized glenospheres. Methods We retrospectively reviewed 154 consecutive patients undergoing RSA between July 2015 and July 2017 by one single-fellowship trained surgeon (AJ). Two raters (KAM and MVS) independently measured glenoid inclination in preoperative and minimum two year follow-up radiographs (anteroposterior/Grashey) using the RSA angle. Inclination was then compared to patient-reported outcomes, range of motion (ROM), and independently assessed degree of scapular notching and staging of heterotopic ossification at two year follow-up. Results Median postoperative inclination for each group was found to be -3.6° (interquartile range (IQR) -2.1 to -6.9) and 6.0° (3.2° to 10.1°) for the neutrally/inferiorly and superiorly inclined cohorts, respectively. Preoperative inclination was highly associated with postoperative inclination (p = 0.004). When comparing superiorly and neutrally/inferiorly inclined glenospheres, there were no differences in heterotopic ossification (p = 0.606), scapular notching (p = 0.367), American Shoulder and Elbow Surgeons score (p = 0.419), Single Assessment Numeric Evaluation (p = 0.417), Visual Analogue Scale (VAS) pain score (p = 0.290), forward elevation (p = 0.161), external rotation (p = 0.537), or internal rotation (p = 0.656). Conclusion Compared to neutral and inferior inclination, up to 6° ± 3° of superior glenoid baseplate inclination on a lateralized RSA design produces no differences in postoperative ROM or patient-reported outcomes, and produces similar levels of scapular notching and heterotopic ossification. Additionally, the degree of preoperative inclination represents an important factor in surgical decision-making as it is strongly associated with postoperative inclination. It is important to note that the findings of this study are only reflective of lateralized RSA prostheses. Cite this article: Bone Joint J 2021;103-B(2):360–365.

scholarly journals Heterotopic Ossification of the Brachial Plexus After Reverse Total Shoulder Arthroplasty

2018 ◽  
Vol 2 ◽  
pp. 247154921880777 ◽  
Author(s):  
Patrick K Riggle ◽  
Brett G Brazier ◽  
C Luke Wilcox
Keyword(s):  
Brachial Plexus ◽  
Heterotopic Ossification ◽  
Shoulder Arthroplasty ◽  
Proximal Humerus Fracture ◽  
Axillary Artery ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Fracture Dislocation ◽  
Brachial Plexopathy ◽  
Reverse Total Shoulder

In the following report, we present the case of a patient who presented with a proximal humerus fracture dislocation and an associated brachial plexopathy. After undergoing a reverse total shoulder arthroplasty, the brachial plexopathy showed signs of improvement plateaued until the patient started having increased pain in the involved extremity and the brachial plexopathy began to worsen. At that time, it was discovered that the patient had heterotopic ossification (HO) encasing the brachial plexus and axillary artery. To our knowledge, this is the first reported case of HO involving the brachial plexus and axillary artery.

Complication and revision rates after reverse total shoulder revision from hemiarthroplasty: a systematic review

2021 ◽  
pp. 175857322110193
Author(s):  
Arjun K Reddy ◽  
Jake X Checketts ◽  
B Joshua Stephens ◽  
J Michael Anderson ◽  
Craig M Cooper ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Arthroplasty ◽  
Revisional Surgery ◽  
Total Shoulder Arthroplasty ◽  
Surgical Site Infections ◽  
Total Sample ◽  
Reverse Total Shoulder Arthroplasty ◽  
Common Complication ◽  
Humeral Component ◽  
Reverse Total Shoulder

Background Thus, the purpose of the present study was to (1) characterize common postoperative complications and (2) quantify the rates of revision in patients undergoing hemiarthroplasty to reverse total shoulder arthroplasty revisional surgery. We hypothesize that hardware loosenings will be the most common complication to occur in the sample, with the humeral component being the most common loosening. Methods This systematic review adhered to PRISMA reporting guideline. For our inclusion criteria, we included any study that contained intraoperative and/or postoperative complication data, and revision rates on patients who had undergone revision reverse total shoulder arthroplasty due to a failed hemiarthroplasty. Complications include neurologic injury, deep surgical site infections, hardware loosening/prosthetic instability, and postoperative fractures (acromion, glenoid, and humeral fractures). Results The study contained 22 studies that assessed complications from shoulders that had revision reverse total shoulder arthroplasty from a hemiarthroplasty, with a total sample of 925 shoulders. We found that the most common complication to occur was hardware loosenings (5.3%), and of the hardware loosenings, humeral loosenings (3.8%) were the most common. The revision rate was found to be 10.7%. Conclusion This systematic review found that revision reverse total shoulder arthroplasty for failed hemiarthroplasty has a high overall complication and reintervention rates, specifically for hardware loosening and revision rates.

Assessment of glenoid baseplate initial micromotion and fixation strength in reverse total shoulder arthroplasty designs using a direct shear force methodology

2021 ◽  
pp. 175857322110329
Author(s):  
Therese E Parr ◽  
Jennifer K Anderson ◽  
Alan M. Marionneaux ◽  
John M Tokish ◽  
Stefan J Tolan ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Shear Force ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Fixation Strength ◽  
Shoulder Prosthesis ◽  
Direct Shear ◽  
Device Failure ◽  
Glenoid Baseplate ◽  
Reverse Total Shoulder

Background In a reverse total shoulder arthroplasty, the altered glenohumeral joint center of rotation subjects the glenoid baseplate to increased shear forces and potential loosening. Methods This study examined glenoid baseplate micromotion and initial fixation strength with the application of direct shear force in a Sawbone model. The reverse total shoulder arthroplasty systems examined were the DJO Reverse® Shoulder Prosthesis, the Exactech Equinoxe® Reverse System, and the Tornier AequalisTM Reverse Shoulder Prosthesis. Specimens were cyclically tested with increasing shear loads until 150 µm of displacement between the implant and glenoid was achieved, and subsequently until failure, classified as either 1 cm of implant/glenoid displacement or fracture. Results The average load withstood for the 150 µm threshold for DJO, Tornier, and Exactech was 460 ± 88 N, 525 ± 100 N, and 585 ± 160 N, respectively. The average total load at device failure for DJO, Tornier, and Exactech was 980 ± 260 N, 1260 ± 120 N, and 1350 ± 230 N, respectively. Discussion The Exactech implant design trended toward requiring more load to induce micromotion at each threshold and to induce device failure, most commonly seen as inferior screw pull out. This study proposes design features that may enhance fixation and suggests little risk of initial micromotion or failure during initial post-operative recovery.

Scapular and Humeral Elevation Coordination Patterns Used Before vs. After Reverse Total Shoulder Arthroplasty

2021 ◽  
pp. 110550
Author(s):  
Antonia M. Zaferiou ◽  
Christopher B. Knowlton ◽  
Suk-Hwan Jang ◽  
Bryan M. Saltzman ◽  
Nikhil N. Verma ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Coordination Patterns ◽  
Reverse Total Shoulder
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