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Reverse shoulder arthroplasty with a short metaphyseal humeral stem

Ehud Atoun, Alexander Van Tongel UGent, Nir Hous, Ali Narvani, Jai Relwani, Ruben Abraham and Ofer Levy (2014) INTERNATIONAL ORTHOPAEDICS. 38(6). p.1213-1218
abstract
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 degrees and from 41.6 to 116.5 degrees 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.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
CUFF, COMPLICATIONS, FRACTURES, SURFACE REPLACEMENT ARTHROPLASTY, PROSTHESIS, OSTEOARTHRITIS, EPIDEMIOLOGY, ARTHRITIS
journal title
INTERNATIONAL ORTHOPAEDICS
Int. Orthop.
volume
38
issue
6
pages
1213 - 1218
Web of Science type
Article
Web of Science id
000336601000013
JCR category
ORTHOPEDICS
JCR impact factor
2.11 (2014)
JCR rank
22/72 (2014)
JCR quartile
2 (2014)
ISSN
0341-2695
DOI
10.1007/s00264-014-2328-8
language
English
UGent publication?
no
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
7053060
handle
http://hdl.handle.net/1854/LU-7053060
date created
2016-01-26 10:30:09
date last changed
2016-12-19 15:43:36
@article{7053060,
  abstract     = {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 degrees and from 41.6 to 116.5 degrees 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.},
  author       = {Atoun, Ehud and Van Tongel, Alexander and Hous, Nir and Narvani, Ali and Relwani, Jai and Abraham, Ruben and Levy, Ofer},
  issn         = {0341-2695},
  journal      = {INTERNATIONAL ORTHOPAEDICS},
  keyword      = {CUFF,COMPLICATIONS,FRACTURES,SURFACE REPLACEMENT ARTHROPLASTY,PROSTHESIS,OSTEOARTHRITIS,EPIDEMIOLOGY,ARTHRITIS},
  language     = {eng},
  number       = {6},
  pages        = {1213--1218},
  title        = {Reverse shoulder arthroplasty with a short metaphyseal humeral stem},
  url          = {http://dx.doi.org/10.1007/s00264-014-2328-8},
  volume       = {38},
  year         = {2014},
}

Chicago
Atoun, Ehud, Alexander Van Tongel, Nir Hous, Ali Narvani, Jai Relwani, Ruben Abraham, and Ofer Levy. 2014. “Reverse Shoulder Arthroplasty with a Short Metaphyseal Humeral Stem.” International Orthopaedics 38 (6): 1213–1218.
APA
Atoun, E., Van Tongel, A., Hous, N., Narvani, A., Relwani, J., Abraham, R., & Levy, O. (2014). Reverse shoulder arthroplasty with a short metaphyseal humeral stem. INTERNATIONAL ORTHOPAEDICS, 38(6), 1213–1218.
Vancouver
1.
Atoun E, Van Tongel A, Hous N, Narvani A, Relwani J, Abraham R, et al. Reverse shoulder arthroplasty with a short metaphyseal humeral stem. INTERNATIONAL ORTHOPAEDICS. 2014;38(6):1213–8.
MLA
Atoun, Ehud, Alexander Van Tongel, Nir Hous, et al. “Reverse Shoulder Arthroplasty with a Short Metaphyseal Humeral Stem.” INTERNATIONAL ORTHOPAEDICS 38.6 (2014): 1213–1218. Print.