TY - JOUR
T1 - Reverse shoulder arthroplasty with a short metaphyseal humeral stem
AU - Atoun, Ehud
AU - Van Tongel, Alexander
AU - Hous, Nir
AU - Narvani, Ali
AU - Relwani, Jai
AU - Abraham, Ruben
AU - Levy, Ofer
PY - 2014/1/1
Y1 - 2014/1/1
N2 - Purpose: Reverse shoulder prostheses have been gaining popularity in recent years. A short metaphyseal stem design will allow bone stock preservation and minimize stem related complications. We examined the clinical and radiographic short-term outcome of a short metaphyseal stem reverse shoulder arthroplasty. Methods: Thirty-one patients, with a mean follow-up of 36 months (24 - 52), were evaluated clinically with the Constant-Murley score, patient satisfaction and pain relief scores. The fixation of the glenoid and humeral components, subsidence and notching were evaluated on radiographs. The indications were cuff tear arthropathy (22), fracture sequelae (five) and rheumatoid arthritis (four). Results: The average Constant score improved from 12.7 (range two to 31) pre-operatively to 56.2 (range 17-86) post-operatively. It rose from 13.5 to 58.3 in patients with Cuff arthropathy, from 15.8 to 62.0 in revision arthroplasty, from 10.2 to 47.4 in those with fracture sequelae, and from 11.5 to 55.3 in patients with rheumatoid arthritis. The overall mean patient satisfaction score improved from 2.4/10 to 8.5/10 and mean pain score improved from 0.8/15 to 12.5/15. We found an overall improvement in active forward flexion from 46.8 to 128.5° and from 41.6 to 116.5° in abduction. No humeral loosening or subsidence was observed. Two cases of grade 1-2 glenoid notching were reported. Overall there were three intra-operative fractures that did not affect the operation and healed without affecting the good results. There were five late traumatic periprosthetic fractures, only one of them required a revision surgery to a stemmed implant and the rest healed without surgery. There were two early dislocations that had to be revised. Conclusions: The clinical and radiographic evaluation of a bone preserving metaphyseal humeral component in reverse shoulder arthroplasty is promising, with good clinical results, no signs of loosening or subsidence.
AB - Purpose: Reverse shoulder prostheses have been gaining popularity in recent years. A short metaphyseal stem design will allow bone stock preservation and minimize stem related complications. We examined the clinical and radiographic short-term outcome of a short metaphyseal stem reverse shoulder arthroplasty. Methods: Thirty-one patients, with a mean follow-up of 36 months (24 - 52), were evaluated clinically with the Constant-Murley score, patient satisfaction and pain relief scores. The fixation of the glenoid and humeral components, subsidence and notching were evaluated on radiographs. The indications were cuff tear arthropathy (22), fracture sequelae (five) and rheumatoid arthritis (four). Results: The average Constant score improved from 12.7 (range two to 31) pre-operatively to 56.2 (range 17-86) post-operatively. It rose from 13.5 to 58.3 in patients with Cuff arthropathy, from 15.8 to 62.0 in revision arthroplasty, from 10.2 to 47.4 in those with fracture sequelae, and from 11.5 to 55.3 in patients with rheumatoid arthritis. The overall mean patient satisfaction score improved from 2.4/10 to 8.5/10 and mean pain score improved from 0.8/15 to 12.5/15. We found an overall improvement in active forward flexion from 46.8 to 128.5° and from 41.6 to 116.5° in abduction. No humeral loosening or subsidence was observed. Two cases of grade 1-2 glenoid notching were reported. Overall there were three intra-operative fractures that did not affect the operation and healed without affecting the good results. There were five late traumatic periprosthetic fractures, only one of them required a revision surgery to a stemmed implant and the rest healed without surgery. There were two early dislocations that had to be revised. Conclusions: The clinical and radiographic evaluation of a bone preserving metaphyseal humeral component in reverse shoulder arthroplasty is promising, with good clinical results, no signs of loosening or subsidence.
UR - http://www.scopus.com/inward/record.url?scp=84904565280&partnerID=8YFLogxK
U2 - 10.1007/s00264-014-2328-8
DO - 10.1007/s00264-014-2328-8
M3 - Article
C2 - 24705690
AN - SCOPUS:84904565280
SN - 0341-2695
VL - 38
SP - 1213
EP - 1218
JO - International Orthopaedics
JF - International Orthopaedics
IS - 6
ER -