Abstract
From 1993 to 2008, 44 DELTA III prostheses were implanted for 33 three-part and four-part displacements and 11 fracture-dislocations, in 3 males for 41 females, with an average age of seventy five years. The results were estimated with AP and profile X-rays.
Ten patients died and and three moved. Thirty one cases were reviewed with a mean follow-up of 6.3 years, range 1 to 15. The radiographs showed:
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two 2-mm thick borders on the glenoid at four and eight years.
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one aseptic loosening of the base plate at twelve years with a broken polar inferior screw.
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nineteen inferior scapular notches at a mean occurrence time of 4.6 years: the longer the follow-up, the more severe the notch with two distinct patters of notches: mechanical, stable, because of an impingement between the humeral component and the pillar and biological, progressive in size, evolving over time with proximal humeral bone loss (five medial resorptions and three bone-cement interface medial borders) because of polyethylene disease.
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fourteen inferior spurs, stable after emergence at a mean occurrence time of 2.5 years.
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one joint ossification at 6 months and stable at 6 years.
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one septic humeral loosening at 2 years.
In elderly patients with trauma, when attachment of the tubercles on the classical orthopaedics devices is impossible, the use of a RSA leads to precocious worrying and progressive images but with only one re-intervention for an aseptic loosening of the base plate at a twelve year evolution. New developments in design and bearing surfaces, new surgical techniques of implantation and a more long term results will probably provide more durable utilization of the reverse concept for this indication.
The abstracts were prepared by Mr Matt Costa and Mr Ben Ollivere. Correspondence should be addressed to Mr Costa at Clinical Sciences Research Institute, University of Warwick, Clifford Bridge Road, Coventry CV2 2DX, UK.
