Análisis clínico y radiológico de la prótesis reversa: Problemas y complicaciones en 6 años de experiencia
Keywords:
shoulder joint surgery, arthroplasty, replacement, joint prosthesis, treatment outcomeAbstract
Introduction: The main indications for the total reverse arthroplasty are patients with chronic severe rotator cuff shoulder arthropathy, chronic painful shoulder pseudoparalysis, proximal humeral multifragmentary fractures in old patients, failed hemiarthroplasty revision surgery and post-traumatic glenohumeral arthrosis.
Methods: This is a descriptive, retrospective study. Clinical results were assessed with Constant and Murley functional scale for clinical and functional evaluation. True anterior posterior, lateral scapular and axillary X-ray views were used for the radiological evaluation and finally patient satisfaction was ruled through the question number eighteen UCLA scale in 21 patients (23 shoulders).
Results: The average following time for patients was 24.8 months, the total average Constant-Murley score was 63.5 (highest score 79 and lowest 38). Complications found included: One patient with ulnar nerve neuropraxia, two deep infections that required prosthesis removal, one glenoid loosening case, one screw fracture, a lesser tuberosity displacement and finally only one scapular notching with no concomitant loosening or glenoid instability.
Discussion: Our results confirm that reverse shoulder arthroplasty is a reliable alternative since shoulder function and life quality in adequately chosen patients is improved. Complications are present and prevention is a definite key to optimal results.
Downloads
References
Jaramillo-F JC, Arismendi MA, Duque-T JJ, Jost B. Análisis clínico y radiológico de la prótesis reversa: reporte preliminar. Rev Col Or Tra 2009; 23(1): 40-6.
Zumstein M, Pinedo M, Old J, Boileau P. Problems, complications, reoperations and revisions in reverse total shoulder arthroplasty: a systematic review. J Shoulder Elbow Surg 2011; 20(1): 146-57. https://doi.org/10.1016/j.jse.2010.08.001
Molé D, Favard L. Excentered scapulohumeral osteoarthritis. Rev Chir Orthop Reparatrice Appar Mot 2007; 93(6 Suppl): 37-94. https://doi.org/10.1016/S0035-1040(07)92713-0
Wall B, Nove-Josserand L, O'Connor DP, Edwards TB, Walch G. Reverse total shoulder arthroplasty: a review of results according to etiology. J Bone Joint Surg Am 2007; 89(7): 1476-85. https://doi.org/10.2106/JBJS.F.00666
Boileau P, Gonzalez JF, Chuinard C, Bicknell R, Walch G. Reverse total shoulder arthroplasty after failed rotator cuff surgery. J Shoulder Elbow Surg 2009; 18(4): 600-6. https://doi.org/10.1016/j.jse.2009.03.011
Boileau P, Watkinson DJ, Hatzidakis AM, Balg F. Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elbow Surg 2005; 14(1 Suppl S): 147S-61S. https://doi.org/10.1016/j.jse.2004.10.006
Boulahia A, Edwards TB, Walch G, Baratta RV. Early results of a reverse design prosthesis in the treatment of arthritis of the shoulder in elderly patients with a large rotator cuff tear. Orthopedics 2002; 25(2): 129-33. https://doi.org/10.3928/0147-7447-20020201-16
Cuff D, Pupello D, Virani N, Levy J, Frankle M. Reverse shoulder arthroplasty for the treatment of rotator cuff deficiency. J Bone Joint Surg Am 2008; 90(6): 1244-517. https://doi.org/10.2106/JBJS.G.00775
Gerber C, Pennington SD, Nyffeler RW. Reverse total shoulder arthroplasty. J Am Acad Orthop Surg 2009; 17(5): 284-95. https://doi.org/10.5435/00124635-200905000-00003
Vanhove B, Beugnies A. Grammont's reverse shoulder prosthesis for rotator cuff arthropathy. A retrospective study of 32 cases. Acta Orthop Belg 2004; 70(3): 219-25.
Kontaxis A, Johnson GR. The biomechanics of reverse anatomy shoulder replacement: a modelling study. Clin Biomech (Bristol) 2009; 24(3): 254-60. https://doi.org/10.1016/j.clinbiomech.2008.12.004
Simovitch RW, Zumstein MA, Lohri E, Helmy N, Gerber C. Predictors of scapular notching in patients managed with the Delta III reverse total shoulder replacement. J Bone Joint Surg Am 2007; 89(3): 588-600. https://doi.org/10.2106/JBJS.F.00226
Nyffeler RW, Werner CM, Gerber C. Biomechanical relevance of glenoid component positioning in the reverse Delta III total shoulder prosthesis. J Shoulder Elbow Surg 2005; 14(5): 524-8. https://doi.org/10.1016/j.jse.2004.09.010
Wirth MA, Rockwood CA Jr. Complications of total shoulderreplacement arthroplasty. J Bone Joint Surg Am 1996; 78(4): 603-16. https://doi.org/10.2106/00004623-199604000-00018
Cheung EV, Sperling JW, Cofield RH. Infection associated with hematoma formation after shoulder arthroplasty. Clin Orthop Relat Res 2008; 466(6): 1363-7. https://doi.org/10.1007/s11999-008-0226-3
Fehringer EV, Mikuls TR, Michaud KD, Henderson WG, O'Dell JR. Shoulder arthroplasties have fewer complications than hip or knee arthroplasties in US veterans. Clin Orthop Relat Res 2010; 468(3): 717-22. https://doi.org/10.1007/s11999-009-0996-2
Coste JS, Reig S, Trojani C, Berg M, Walch G, Boileau P. The management of infection in arthroplasty of the shoulder. J Bone Joint Surg Br 2004; 86(1): 65-9. https://doi.org/10.1302/0301-620X.86B1.14089
Walch G, Mottier F, Wall B, Boileau P, Molé D, Favard L. Acromial insufficiency in reverse shoulder arthroplasties. J Shoulder Elbow Surg 2009; 18(3): 495-502. https://doi.org/10.1016/j.jse.2008.12.002
Levy J, Frankle M, Mighell M, Pupello D. The use of the reverse shoulder prosthesis for the treatment of failed hemiarthroplasty for proximal humeral fracture. J Bone Joint Surg Am 2007; 89(2): 292-300. https://doi.org/10.2106/00004623-200702000-00010
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Revista Colombiana de ortopedia y traumatología
This work is licensed under a Creative Commons Attribution 3.0 Unported License.
