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Mid- to long-term outcome of reverse total shoulder arthroplasty as revision procedure for failed hemiarthroplasty after proximal humerus fracture

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Title: Mid- to long-term outcome of reverse total shoulder arthroplasty as revision procedure for failed hemiarthroplasty after proximal humerus fracture
Authors: Paksoy, Alp, Akgün, Doruk, Imiolczyk, Jan-Philipp, Gebauer, Henry, Lacheta, Lucca, Scheibel, Markus, Hayta, Agahan, Moroder, Philipp
Source: BMC Musculoskelet Disord
BMC Musculoskeletal Disorders, Vol 25, Iss 1, Pp 1-10 (2024)
Publisher Information: Springer Science and Business Media LLC, 2024.
Publication Year: 2024
Subject Terms: Male, Reoperation, Revision, Proximal humerus fracture, Diseases of the musculoskeletal system, Research, Shoulder and elbow pathologies, Hemiarthroplasty, Reverse shoulder arthroplasty, Long-term follow-up, Infection, Periprosthetic fracture, Arthroplasty, Prosthesis, Trauma, Grammont reverse prosthesis, Shoulder Joint/diagnostic imaging [MeSH], Aged, 80 and over [MeSH], Aged [MeSH], Arthroplasty, Replacement, Shoulder/methods [MeSH], Reoperation [MeSH], Hemiarthroplasty/methods [MeSH], Male [MeSH], Shoulder Joint/physiopathology [MeSH], Shoulder Fractures/diagnostic imaging [MeSH], Female [MeSH], Follow-Up Studies [MeSH], Humans [MeSH], Shoulder Fractures/surgery [MeSH], Treatment Outcome [MeSH], Retrospective Studies [MeSH], Treatment Failure [MeSH], Range of Motion, Articular [MeSH], Shoulder Joint/surgery [MeSH], Humans, Treatment Failure, Range of Motion, Articular, Aged, Retrospective Studies, Aged, 80 and over, Shoulder Joint, ddc, Treatment Outcome, RC925-935, Arthroplasty, Replacement, Shoulder, Shoulder Fractures, Female, Follow-Up Studies
Description: Background Insufficient tuberosity healing is the most common reason for poor outcome after treatment of proximal humerus fractures (PHFs) using hemiarthroplasty (HA). In these cases, revision to reverse total shoulder arthroplasty (RTSA) can improve function and reduce pain in the short term, however, long-term results remain scarce. Aim of this study was to evaluate the clinical and radiological mid- to long-term results in patients with a revision RTSA after failed HA for PHF. Methods In this retrospective study all patients that received a revision to RTSA after failed fracture HA between 2006 and 2018 were included. A total of 49 shoulders in 48 patients (38 female, 10 male; mean age 82 ± 9 years) were identified in our database. A total of 20 patients (17 female, 3 male; mean age was 79 ± 9 years) were available for follow-up examination after a mean time period of approximately eight years (3–14 years) after revision surgery. At final follow-up, patients were assessed using a subjective shoulder value (SSV), range of motion (ROM), visual analogue score (VAS), the Constant Score (CS) and the 12-Item Short Form Survey (SF-12). Results At final follow-up, mean CS was 55 ± 19 (19–91), VAS averaged 3 ± 3 (0–8) and mean SSV was 61 ± 18% (18–90%). Mean SF-12 was 44 (28–57) with a mean physical component summary (PCS) of 38 (21–56) and a mean mental component summary (MCS) of 51 (29–67). On average active forward flexion (FF) was 104° (10–170°), active abduction (ABD) was 101° (50–170°), active external rotation (ER) was 19° (10–30°) and active internal rotation (IR) of the lumbosacral transition was reached. Three patients presented with a periprosthetic humeral fracture after RTSA implantation and underwent a reoperation (15%) during follow-up period. Conclusions Revision RTSA results in promising clinical results in patients after initial failed HA after PHF. A complication and reoperation rate of 15% is tolerable in consideration of satisfactory functional and psychological outcome. Trial registration Retrospectively registered.
Document Type: Article
Other literature type
File Description: application/pdf
Language: English
ISSN: 1471-2474
DOI: 10.1186/s12891-024-07870-8
Access URL: https://pubmed.ncbi.nlm.nih.gov/39304857
https://doaj.org/article/782db1105fff467ebd152da72d0881cb
https://repository.publisso.de/resource/frl:6495889
https://mediatum.ub.tum.de/doc/1770490/document.pdf
Rights: CC BY
Accession Number: edsair.doi.dedup.....18929e5a872a5f5973189e924fd22ec1
Database: OpenAIRE
Description
Abstract:Background Insufficient tuberosity healing is the most common reason for poor outcome after treatment of proximal humerus fractures (PHFs) using hemiarthroplasty (HA). In these cases, revision to reverse total shoulder arthroplasty (RTSA) can improve function and reduce pain in the short term, however, long-term results remain scarce. Aim of this study was to evaluate the clinical and radiological mid- to long-term results in patients with a revision RTSA after failed HA for PHF. Methods In this retrospective study all patients that received a revision to RTSA after failed fracture HA between 2006 and 2018 were included. A total of 49 shoulders in 48 patients (38 female, 10 male; mean age 82 ± 9 years) were identified in our database. A total of 20 patients (17 female, 3 male; mean age was 79 ± 9 years) were available for follow-up examination after a mean time period of approximately eight years (3–14 years) after revision surgery. At final follow-up, patients were assessed using a subjective shoulder value (SSV), range of motion (ROM), visual analogue score (VAS), the Constant Score (CS) and the 12-Item Short Form Survey (SF-12). Results At final follow-up, mean CS was 55 ± 19 (19–91), VAS averaged 3 ± 3 (0–8) and mean SSV was 61 ± 18% (18–90%). Mean SF-12 was 44 (28–57) with a mean physical component summary (PCS) of 38 (21–56) and a mean mental component summary (MCS) of 51 (29–67). On average active forward flexion (FF) was 104° (10–170°), active abduction (ABD) was 101° (50–170°), active external rotation (ER) was 19° (10–30°) and active internal rotation (IR) of the lumbosacral transition was reached. Three patients presented with a periprosthetic humeral fracture after RTSA implantation and underwent a reoperation (15%) during follow-up period. Conclusions Revision RTSA results in promising clinical results in patients after initial failed HA after PHF. A complication and reoperation rate of 15% is tolerable in consideration of satisfactory functional and psychological outcome. Trial registration Retrospectively registered.
ISSN:14712474
DOI:10.1186/s12891-024-07870-8