The aim of this study was to report the outcomes of different treatment options for glenoid loosening following reverse shoulder arthroplasty (RSA) at a minimum follow-up of two years. We retrospectively studied the records of 79 patients (19 men, 60 women; 84 shoulders) aged 70.4 years (21 to 87) treated for aseptic loosening of the glenosphere following RSA. Clinical evaluation included pre- and post-treatment active anterior elevation (AAE), external rotation, and Constant score.Aims
Patients and Methods
Few studies have compared survivorship of total shoulder arthroplasty (TSA) with hemiarthroplasty (HA). This observational study compared survivorship of TSA with HA while controlling for important covariables and accounting for death as a competing risk. All patients who underwent shoulder arthroplasty in Ontario, Canada between April 2002 and March 2012 were identified using population-based health administrative data. We used the Fine–Gray sub-distribution hazard model to measure the association of arthroplasty type with time to revision surgery (accounting for death as a competing risk) controlling for age, gender, Charlson Comorbidity Index, income quintile, diagnosis, and surgeon factors.Aims
Patients and Methods
The aim of this study was to evaluate the differences in revision and complication rates, functional outcomes, and radiological outcomes between cemented and press-fit humeral stems in primary anatomical total shoulder arthroplasty (TSA). A comprehensive systematic review and meta-analysis was conducted searching for studies that included patients who underwent primary anatomical TSA for primary osteoarthritis or rheumatoid arthritis.Aims
Materials and Methods
A number of methods have been described to remove a well-fixed humeral implant as part of revision shoulder arthroplasty. These include the use of cortical windows and humeral osteotomies. The router bit extraction technique uses a high-speed router bit to disrupt the bone-implant interface. The implant is then struck in a retrograde fashion with a square-tip impactor and mallet. The purpose of this study was to determine the characteristics and frequency of the different techniques needed for the removal of a well-fixed humeral stem in revision shoulder arthroplasty. Between 2010 and 2018, 288 revision shoulder arthroplasty procedures requiring removal of a well-fixed humeral component were carried out at a tertiary referral centre by a single surgeon. The patient demographics, indications for surgery, and method of extraction were collected.Aims
Patients and Methods
Aims
Patients and Methods
To date, no study has considered the impact of acromial morphology on shoulder range of movement (ROM). The purpose of our study was to evaluate the effects of lateralization of the centre of rotation (COR) and neck-shaft angle (NSA) on shoulder ROM after reverse shoulder arthroplasty (RSA) in patients with different scapular morphologies. 3D computer models were constructed from CT scans of 12 patients with a critical shoulder angle (CSA) of 25°, 30°, 35°, and 40°. For each model, shoulder ROM was evaluated at a NSA of 135° and 145°, and lateralization of 0 mm, 5 mm, and 10 mm for seven standardized movements: glenohumeral abduction, adduction, forward flexion, extension, internal rotation with the arm at 90° of abduction, as well as external rotation with the arm at 10° and 90° of abduction.Objectives
Methods
The aim of this study was to investigate the effects of preoperative bisphosphonate treatment on the intra- and postoperative outcomes of arthroplasty of the shoulder. The hypothesis was that previous bisphosphonate treatment would adversely affect both intra- and postoperative outcomes. A retrospective cohort study was conducted involving patients undergoing arthroplasty of the shoulder, at a single institution. Two patients with no previous bisphosphonate treatment were matched to each patient who had received this treatment preoperatively by gender, age, race, ethnicity, body mass index (BMI), and type of arthroplasty. Previous bisphosphonate treatment was defined as treatment occurring during the three-year period before the arthroplasty. The primary outcome measure was the incidence of intraoperative complications and those occurring at one and two years postoperatively. A total of 87 patients were included: 29 in the bisphosphonates-exposed (BP+) group and 58 in the non-exposed (BP-) group. In the BP+ group, there were 26 female and three male patients, with a mean age of 71.4 years (51 to 87). In the BP- group, there were 52 female and six male patients, with a mean age of 72.1 years (53 to 88).Aims
Patients and Methods
The Walch Type C dysplastic glenoid is characterized by excessive
retroversion. This anatomical study describes its morphology. A total of 29 shoulders with a dysplastic glenoid were analyzed.
CT was used to measure retroversion, inclination, height, width,
radius-of-curvature, surface area, depth, subluxation of the humeral
head and the Goutallier classification of fatty infiltration. The
severity of dysplasia and deficiency of the posterior rim of the
glenoid were recorded.Aims
Patients and Methods
The aim of this study was to use national registry database information to estimate cumulative rates and relative risk of revision due to infection after reverse shoulder arthroplasty. We included 17 730 primary shoulder arthroplasties recorded between 2004 and 2013 in The Nordic Arthroplasty Register Association (NARA) data set. With the Kaplan–Meier method, we illustrated the ten-year cumulative rates of revision due to infection and with the Cox regression model, we reported the hazard ratios as a measure of the relative risk of revision due to infection.Aims
Patients and Methods
Shoulder arthroplasty using short humeral components is becoming increasingly popular. Some such components have been associated with relatively high rates of adverse radiological findings. The aim of this retrospective review was to evaluate the radiological humeral bone changes and mechanical failure rates with implantation of a short cementless humeral component in anatomical (TSA) and reverse shoulder arthroplasty (RSA). A total of 100 shoulder arthroplasties (35 TSA and 65 RSA) were evaluated at a mean of 3.8 years (3 to 8.3). The mean age at the time of surgery was 68 years (31 to 90). The mean body mass index was 32.7 kg/m2 (17.3 to 66.4).Aims
Patients and Methods
We present the medium-term clinical results of a reverse total
shoulder arthroplasty with a trabecular metal glenoid base plate. We reviewed 125 consecutive primary reverse total shoulder arthroplasties
(RTSA) implanted in 124 patients for rotator cuff arthropathy. There
were 100 women and 24 men in the study group with a mean age of
76 years (58 to 89). The mean follow-up was 32 months (24 to 60).
No patient was lost to follow-up.Aim
Patients and Methods
The aim of this study was to evaluate the clinical and radiological
outcome of using an anatomical short-stem shoulder prosthesis to
treat primary osteoarthritis of the glenohumeral joint. A total of 66 patients (67 shoulders) with a mean age of 76 years
(63 to 92) were available for clinical and radiological follow-up
at two different timepoints (T1, mean 2.6 years, Aims
Patients and Methods
Inherent disadvantages of reverse shoulder arthroplasty
designs based on the Grammont concept have raised a renewed interest
in less-medialised designs and techniques. The aim of this study
was to evaluate the outcome of reverse shoulder arthroplasty (RSA)
with the fully-constrained, less-medialised, Bayley–Walker prosthesis performed
for the treatment of rotator-cuff-deficient shoulders with glenohumeral
arthritis. A total of 97 arthroplasties in 92 patients (53 women
and 44 men, mean age 67 years (standard deviation ( The Bayley–Walker prosthesis provides reliable pain relief and
reasonable functional improvement for patients with symptomatic
cuff-deficient shoulders. Compared with other designs of RSA, it
offers a modest improvement in forward elevation, but restores external
rotation to some extent and prevents scapular notching. A longer
follow-up is required to assess the survival of the prosthesis and
the clinical performance over time. Cite this article:
We assessed the clinical results, radiographic
outcomes and complications of patients undergoing total shoulder replacement
(TSR) for osteoarthritis with concurrent repair of a full-thickness
rotator cuff tear. Between 1996 and 2010, 45 of 932 patients (4.8%)
undergoing TSR for osteoarthritis underwent rotator cuff repair.
The final study group comprised 33 patients with a mean follow-up
of 4.7 years (3 months to 13 years). Tears were classified into small
(10), medium (14), large (9) or massive (0). On a scale of 1 to
5, pain decreased from a mean of 4.7 to 1.7 (p = <
0.0001), the
mean forward elevation improved from 99° to 139° (p = <
0.0001),
and the mean external rotation improved from 20° (0° to 75°) to
49° (20° to 80°) (p = <
0.0001). The improvement in elevation
was greater in those with a small tear (p = 0.03). Radiographic
evidence of instability developed in six patients with medium or
large tears, indicating lack of rotator cuff healing. In all, six
glenoid components, including one with instability, were radiologically
at risk of loosening. Complications were noted in five patients,
all with medium or large tears; four of these had symptomatic instability
and one sustained a late peri-prosthetic fracture. Four patients
(12%) required further surgery, three with instability and one with
a peri-prosthetic humeral fracture. Consideration should be given to performing rotator cuff repair
for stable shoulders during anatomical TSR, but reverse replacement
should be considered for older, less active patients with larger
tears. Cite this article:
Patients with pain and loss of shoulder function
due to nonunion of a fracture of the proximal third of the humerus may
benefit from reverse total shoulder replacement. This paper reports
a prospective, multicentre study, involving three hospitals and
three surgeons, of 35 patients (28 women, seven men) with a mean
age of 69 years (46 to 83) who underwent a reverse total shoulder
replacement for the treatment of nonunion of a fracture of the proximal humerus.
Using Checchia’s classification, nine nonunions were type I, eight
as type II, 12 as type III and six as type IV. The mean follow-up
was 51 months (24 to 99). Post-operatively, the patients had a significant
decrease in pain (p <
0.001), and a significant improvement in
flexion, abduction, external rotation and Constant score (p <
0.001), but not in internal rotation. A total of nine complications
were recorded in seven patients: six dislocations, one glenoid loosening
in a patient who had previously suffered dislocation, one transitory
paresis of the axillary nerve and one infection. Reverse total shoulder replacement may lead to a significant
reduction in pain, improvement in function and a high degree of
satisfaction. However, the rate of complications, particularly dislocation,
was high. Cite this article:
