scholarly journals Long-term Reverse Total Shoulder Arthroplasty Outcomes: The Effect of the Inferior Shifting of Glenoid Component Fixation

2021 ◽  
Vol 13 ◽  
Author(s):  
Philippe Collotte ◽  
Michael Bercik ◽  
Thais Dutra Vieira ◽  
Gilles Walch
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Glenoid Component ◽  
Reverse Total Shoulder

Long-Term Outcomes of Reverse Total Shoulder Arthroplasty

2017 ◽  
Vol 99 (6) ◽  
pp. 454-461 ◽  
Author(s):  
Guillaume Bacle ◽  
Laurent Nové-Josserand ◽  
Pascal Garaud ◽  
Gilles Walch
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Long Term Outcomes ◽  
Reverse Total Shoulder

scholarly journals Clinical Use of a Computer Assisted Reverse Total Shoulder Arthroplasty System: an Analysis of 1702 Cases

10.29007/hcd6 ◽  
2019 ◽  
Author(s):  
Alexander Greene ◽  
Sandrine Polakovic ◽  
Christopher Roche ◽  
Yifei Dai
Keyword(s):  
Shoulder Arthroplasty ◽  
Preoperative Planning ◽  
Total Shoulder Arthroplasty ◽  
Computer Assisted Surgery ◽  
Reverse Total Shoulder Arthroplasty ◽  
Computer Assisted ◽  
Glenoid Component ◽  
Implant Placement ◽  
Implant Selection ◽  
Reverse Total Shoulder

Placement of the glenoid component in reverse total shoulder arthroplasty (rTSA) is of paramount importance and can affect a patient’s range of motion postoperatively. Preoperative planning and computer assisted surgery (CAS) can improve upon glenoid placement, but such systems for rTSA have experienced limited commercial success. Postoperative surgical reports from the first 1702 clinical cases of a commercially available CAS rTSA system were collected and analyzed for implant selection, implant placement, and incision start to incision close operative time, and compared to similar date cohorts for non-navigated cases. Navigated rTSA cases had a significantly longer incision time than non-navigated cases. Augmented glenoid components were used in a much higher percentage of navigated cases than non-navigated cases, suggesting that augmented glenoid components provide utility for correcting pathologic glenoid wear. The average resultant version and inclination of the implanted component increased with the size of augment used, suggesting there may not be a clear consensus on optimal version or inclination. Long term clinical follow up will need to be collected to determine if preoperative planning combined with more precise and accurate glenoid component positioning leads to improved clinical outcomes and implant longevity.

scholarly journals Conversion to Reverse Total Shoulder Arthroplasty with and without Humeral Stem Retention: Mid-to Long-Term Results

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Marios Loucas ◽  
Rafael Loucas ◽  
Philipp Kriechling ◽  
Samy Bouaicha ◽  
Karl Wieser
Keyword(s):  
Shoulder Arthroplasty ◽  
Revision Rate ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Long Term Results ◽  
Surgical Time ◽  
Stem Revision ◽  
Stem Retention ◽  
Reverse Total Shoulder

Background: Over the past decade, conversion to Reverse Total Shoulder Arthroplasty (RTSA) has become the preferred treatment for revision of an Anatomic Hemi (HA) or Total Shoulder Arthroplasty (TSA). However, conversion of failed stemmed shoulder arthroplasty to RTSA is still a highly demanding procedure and carries unique technical challenges and risks. Questions/Purposes: This study aimed to analyze the mid- to long-term results after conversion of failed anatomical shoulder arthroplasty to RTSA and investigate whether preserving the humeral stem offers advantages over revising the humeral stem. Materials and Methods: Between 2005 and 2018, 99 hemiarthroplasties and 62 total shoulder arthroplasties (total =161 shoulders; 157 patients) were revised to RTSA without (n=47) or with (n=114) stem exchange. Complications and revisions were documented from medical and surgical records. Longitudinal pre- and post-operative clinical (Constant-Murley (CS) score, Subjective Shoulder Value (SSV)), and radiographic outcomes were assessed. Complete clinical and radiographic follow-up was available on 80% of shoulders (127 patients; 128 of 161 procedures, 46 without and 82 with stem exchange) at a minimum of 24 months and a mean of 70 months (range, 24 to 184 months). Results: Humeral stem retention was associated with a significantly reduced surgical time (193 min vs. 227 min, p=0.001, less blood loss (591 mL vs. 753 mL, p=0.037), less intraoperative complications (13% vs. 19%; Odds Ratio (OR), 1.4, p=0.32) and fewer subsequent reinterventions (19% vs. 28%; OR, 2.3, p=0.06). The complication/revision rate leading to drop out from the study was considerable in the stem revision group (ten patients; ten of 114 shoulders (9%)), but there were no complication-related dropouts in the stem-retaining group. Conclusion: Our findings suggest that humeral stem revision is associated with decreased surgical time, less blood loss, less intra- and postoperative complications, and a lower revision rate compared to humeral stem retention. Based on these findings, a shoulder arthroplasty system modularity offers substantial benefit if conversion to reverse total shoulder arthroplasty becomes necessary. Level of Evidence: Level III, therapeutic study.

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