Revision for a failed reverse: a 12-year review of a lateralized implant
| Autor: | Peter Simon, Brent Stephens, Kaitlyn N. Christmas, Geoffrey P. Stone, Adam J. Lorenzetti, Rachel Clark, Mark A. Frankle |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Prosthesis-Related Infections medicine.medical_treatment Elbow Periprosthetic Reverse shoulder Prosthesis Design 03 medical and health sciences 0302 clinical medicine medicine Operative report Humans Orthopedics and Sports Medicine Revision rate Range of Motion Articular Aged Retrospective Studies 030222 orthopedics business.industry Shoulder Joint Shoulder Dislocation Shoulder Prosthesis 030229 sport sciences General Medicine Middle Aged Arthroplasty Surgery Prosthesis Failure medicine.anatomical_structure Treatment Outcome Arthroplasty Replacement Shoulder Female Implant Hemiarthroplasty Periprosthetic Fractures business Range of motion |
| Zdroj: | Journal of shoulder and elbow surgery. 25(5) |
| ISSN: | 1532-6500 |
| Popis: | Background The purpose of this study was (1) to evaluate the rates of reverse shoulder arthroplasty (RSA) revisions during a 12-year period, (2) to assess the influence of primary diagnosis and the impact of implant modifications on revisions, (3) to describe surgical management of failed RSA, and (4) to analyze outcomes of patients with minimum 24-month follow-up. Methods A retrospective database review identified primary diagnosis for 1418 patients who underwent RSA from 2000 to 2012. A subgroup of 85 patients required return to the operating room for removal or exchange of components. Indication to reoperate, intraoperative management, and outcomes were reviewed. Indications were grouped into 7 categories: baseplate failure, humeral component dissociation, glenosphere dissociation, glenohumeral dislocation, aseptic humeral loosening, periprosthetic fracture, and infection. During the study, design modifications were made to the baseplate, humeral socket, and glenosphere. Surgical strategies were analyzed through operative reports. Range of motion, American Shoulder and Elbow Surgeons scores, and Simple Shoulder Test scores were collected before and after surgery and compared for 58 patients with 2-year follow-up. Results Overall revision rate was 6%. Patients undergoing RSA for failed hemiarthroplasty had the highest revision rate (10%). Indications for revision included baseplate failure (2.5%), infection (1.3%), humeral dissociation (0.7%), glenosphere dissociation (0.6%), periprosthetic fracture (0.4%), glenohumeral dislocation (0.4%), and aseptic humeral loosening (0.3%). Baseplate modifications reduced the incidence of baseplate failure to 0.3%. Range of motion and the Simple Shoulder Test and American Shoulder and Elbow Surgeons scores improved. Conclusion Although revision RSA is challenging, with higher risk for complications compared with primary RSA, patients still exhibit significant clinical improvements. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect