Restoration of internal rotation after reverse shoulder arthroplasty may vary depending on etiology in patients younger than 60 years of age: a multicenter retrospective study.
| Autor: | Berhouet J; Université de Tours, Faculté de Médecine de Tours, CHRU Trousseau Service d'Orthopédie Traumatologie, 1C Avenue de la République, 37170 Chambray-les-Tours, France; Université de Tours, Ecole d'Ingénieurs Polytechnique Universitaire de Tours, Laboratoire d'Informatique Fondamentale et Appliquée de Tours EA6300, Equipe Reconnaissance de Forme et Analyse de l'Image, 64 Avenue Portalis, 37200 Tours, France., Samargandi R; Université de Tours, Faculté de Médecine de Tours, CHRU Trousseau Service d'Orthopédie Traumatologie, 1C Avenue de la République, 37170 Chambray-les-Tours, France; Department of Orthopedic Surgery, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia. Electronic address: Ramy.samargandi@hotmail.com., Jacquot A; Centre Artics, 24 rue du XXI Régiment d'Aviation, 54000 Nancy, France., Favard L; Université de Tours, Faculté de Médecine de Tours, CHRU Trousseau Service d'Orthopédie Traumatologie, 1C Avenue de la République, 37170 Chambray-les-Tours, France., Boileau P; Institut de Chirurgie Réparatrice-Groupe Kantys, 06004 Nice, France., Gauci MO; Chirurgie Orthopédique, Institut Universitaire Locomoteur et du Sport, CHU de Nice Hôpital Pasteur II, 30 Voie Romaine, 06000 Nice, France. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of ISAKOS : joint disorders & orthopaedic sports medicine [J ISAKOS] 2024 Aug; Vol. 9 (4), pp. 620-627. Date of Electronic Publication: 2024 Jun 06. |
| DOI: | 10.1016/j.jisako.2024.05.016 |
| Abstrakt: | Background: Reverse shoulder arthroplasty (RSA) offers promising functional outcomes for young patients, yet challenges persist in restoring internal rotation (IR). This study aimed to assess the restoration of IR after RSA in patients younger than 60 years of age and analyze the factors affecting IR recovery. Methods: A retrospective multicenter study was conducted, examining the functional outcome of patients who underwent RSA, with a minimum follow-up period of 2 years. Two subgroups of patients who underwent primary RSA were analyzed separately with respect to active internal rotation with the elbow at the side (AIR1): "difficult AIR1" and "easy AIR1." Results: The study included 136 patients (overall series) with a mean age of 51.6 years. The overall series showed statistically significant improvement in active range of motion (RoM), pain, and Constant scores, especially with active IR (p < 0.01). According to etiology, statistically significant improvement (p < 0.05) in active IR was observed for fracture sequelae, primary osteoarthritis, and rheumatoid arthritis, whereas no statistically significant improvement in IR was observed for tumor, revision, and cuff-tear arthropathy (p > 0.05). In subgroup analysis, patients with easy AIR1 displayed a statistically significant lower body mass index and better Constant score mobility, as well as improved motion in forward elevation and active IR (p < 0.05). No statistically significant associations were found between improved IR and prosthetic design or subscapularis repair. Scapular notch, lysis of the graft, and teres minor atrophy were significantly associated with better active IR (p < 0.05). Conclusion: RSA improves active RoM, pain, and functional outcomes in patients aged under 60. However, the degree of improvement in IR may vary depending on several factors and the underlying etiologies. These insights are crucial for patient selection and counseling, guiding RSA optimization efforts. Level of Evidence: IV. Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest in relation to the research, authorship, and/or publication of this work. (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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