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      Reverse total shoulder arthroplasty

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          Abstract

          • Since the introduction of reverse total shoulder arthroplasty (RTSA) in 1987 (in Europe) and 2004 (in the United States), the number of RTSAs performed annually has increased.

          • Although the main indication for RTSA has been rotator cuff tears, indications have expanded to include several shoulder conditions, many of which involve dysfunction of the rotator cuff.

          • RTSA complications have been reported to affect 19% to 68% of patients and include acromial fracture, haematoma, infection, instability, mechanical baseplate failure, neurological injury, periprosthetic fracture and scapular notching.

          • Current controversies in RTSA include optimal baseplate positioning, humeral neck-shaft angle (135° versus 155°), glenosphere placement (medial, lateral or bony increased offset RTSA) and subscapularis repair.

          • Improvements in prosthesis design, surgeon experience and clinical results will need to occur to optimize this treatment for many shoulder conditions.

          Cite this article: EFORT Open Rev 2018;3:58–69 DOI: 10.1302/2058-5241.3.170044

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          Displaced proximal humeral fractures. I. Classification and evaluation.

          C S Neer (1970)
          Article 0 comments Cited 235 times – based on 0 reviews     Review now
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            Increasing incidence of shoulder arthroplasty in the United States.

            Yuqing Zhang, Sarah B Wise, H. Kim … (2011)
            The number of total shoulder arthroplasties performed in the United States increased slightly between 1990 and 2000. However, the incidence of shoulder arthroplasty in recent years has not been well described. The purpose of the present study was to examine recent trends in shoulder hemiarthroplasty and total shoulder arthroplasty along with the common reasons for these surgical procedures in the United States. We modeled the incidence of shoulder arthroplasty from 1993 to 2008 with use of the Nationwide Inpatient Sample. On the basis of hemiarthroplasty and total shoulder arthroplasty cases that were identified with use of surgical procedure codes, we conducted a design-based analysis to calculate national estimates. While the annual number of hemiarthroplasties grew steadily, the number of total shoulder arthroplasties showed a discontinuous jump (p < 0.01) in 2004 and increased with a steeper linear slope (p < 0.01) since then. As a result, more total shoulder arthroplasties than hemiarthroplasties have been performed annually since 2006. Approximately 27,000 total shoulder arthroplasties and 20,000 hemiarthroplasties were performed in 2008. More than two-thirds of total shoulder arthroplasties were performed in adults with an age of sixty-five years or more. Osteoarthritis was the primary diagnosis for 43% of hemiarthroplasties and 77% of total shoulder arthroplasties in 2008, with fracture of the humerus as the next most common primary diagnosis leading to hemiarthroplasty. The number of shoulder arthroplasties, particularly total shoulder arthroplasties, is growing faster than ever. The use of reverse total arthroplasty, which was approved by the United States Food and Drug Administration in November 2003, may be part of the reason for the greater increase in the number of total shoulder arthroplasties. A long-term follow-up study is warranted to evaluate total shoulder arthroplasty in terms of patient outcomes, safety, and implant longevity.
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              Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders.

              F Sirveaux, L Favard, D Oudet … (2004)
              We reviewed 80 shoulders (77 patients) at a mean follow-up of 44 months after insertion of a Grammont inverted shoulder prosthesis. Three implants had failed and had been revised. The mean Constant score had increased from 22.6 points pre-operatively to 65.6 points at review. In 96% of these shoulders there was no or only minimal pain. The mean active forward elevation increased from 73 degrees to 138 degrees. The integrity of teres minor is essential for the recovery of external rotation and significantly influenced the Constant score. Five cases of aseptic loosening of the glenoid and seven of dissociation of the glenoid component were noted. This study confirms the promising early results obtained with the inverted prosthesis in the treatment of a cuff-tear arthropathy. It should be considered in the treatment of osteoarthritis with a massive tear of the cuff but should be reserved for elderly patients.
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                Author and article information

                Journal
                Journal ID (nlm-ta): EFORT Open Rev
                Journal ID (iso-abbrev): EFORT Open Rev
                Title: EFORT Open Reviews
                Publisher: British Editorial Society of Bone and Joint Surgery
                ISSN (Electronic): 2058-5241
                Publication date Collection: February 2018
                Publication date (Electronic): 28 February 2018
                Volume: 3
                Issue: 2
                Pages: 58-69
                Affiliations
                [1 ]Department of Orthopaedics and Traumatology, Villa del Sole Clinic, Italy
                [2 ]Division of Shoulder Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, USA
                [3 ]Department of Orthopaedics and Traumatology, Hacettepe University, Turkey
                Author notes
                [*]G. Huri, Hacettepe University School of Medicine, Orthopaedics and Traumatology Department, Hacettepe University, Ankara 06100, Turkey. Email: gazihuri@ 123456yahoo.com
                Article
                Publisher ID: 10.1302_2058-5241.3.170044
                DOI: 10.1302/2058-5241.3.170044
                PMC ID: 5890133
                PubMed ID: 29657846
                SO-VID: 9f2957db-6abe-47b0-a9e8-88729e202dce
                Copyright © © 2018 The author(s)
                License:

                This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.

                History
                Categories
                Subject: Shoulder & Elbow
                Subject: 12
                Subject: Reverse Total Shoulder Arthroplasty
                Subject: Indications
                Subject: Contraindications
                Subject: Clinical Outcomes
                Subject: Complications

                Keywords: reverse total shoulder arthroplasty,indications,contraindications,clinical outcomes,complications
                Data availability:
                Keywords: reverse total shoulder arthroplasty, indications, contraindications, clinical outcomes, complications

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