These authors present the clinical and radiologic outcomes at 2 to 7 years of 98 patients (20 men, 78 women) receiving a short metaphyseal reverse total shoulder arthroplasty (rTSA) prosthesis without a diaphyseal stem.
Mean age was 74.4 years (range, 38-93 years). Indications were cuff tear arthropathy, 65; fracture sequelae, 12; rheumatoid arthritis, 13; failed rotator cuff repair, 3; cuff deficiency with loosening of anatomic prosthesis, 3; and acute trauma, 2; 17 of these were revisions.
Patients’ satisfaction (Subjective Shoulder Value) improved from 8 of 100 to 85 of 100. The Constant score improved from 14 to 59 (age- and sex-adjusted, 86; P < .0001). Range of motion improved from 47° to 129° in elevation, 10° to 51° in external rotation, and 21° to 65° in internal rotation.
21 patients (21%) had glenoid notching (18 grade 1-2; 3 grade 3). Other complications included
2 undisplaced fractures of the humeral metaphysis due to excessive bone impaction
1 glenoid rim cracked during preparation
2 early dislocations; 1 patient put weight on his shoulder in extension of the shoulder (to push himself out of chair) 1 week after surgery. The other was caused by an inferior osteophyte that hinged the liner to dislocate.
1 glenoid head disengaged from the baseplate due to soft tissue interposition
2 acromial fractures
6 late traumatic periprosthetic fractures caused by falls - two glenoid fractures and three proximal humeral (metaphyseal) fractures.
2 acromial fractures
6 late traumatic periprosthetic fractures caused by falls - two glenoid fractures and three proximal humeral (metaphyseal) fractures.
1 displaced metaphyseal-diaphyseal periprosthetic fracture
. Comment: While metaphyseal humeral components without a stem were developed to minimize bone resection and preserve bone,
it is unclear that they preserve more bone than an impaction grafted thin stem. Compare the x-ray above to one taken for our case from yesterday shown below. We fix the humeral component with impaction autografting, minimizing the risk of fracture at surgery and after.
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. Comment: While metaphyseal humeral components without a stem were developed to minimize bone resection and preserve bone,
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You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
