Saturday, October 17, 2020

Adverse events after reverse total shoulder at two years

Short-term safety, function, and quality of life in patients treated with Univers Revers prosthesis: a multicenter 2-year follow-up case series

These authors reviews the rate of local complications and outcomes during the first 2 years after RTSA with the Univers Revers prosthesis performed for rotator cuff arthropathy. 

Of 187 patients, 59.4% were women, and the mean age was 75.3 years (range, 56-91 years). 

Overall, 65 local adverse events (AEs ) were documented in 51 patients (27%, 51 of 187). 

Five AEs occurred intraoperatively; all were local, and none were severe or had serious medical

consequences. Three intraoperative AEs were possibly linked to the implant. In the first patient, the screw head broke during insertion; in the second, the screw could not be inserted at all; and in the third, a fissure fracture of the lateral greater tuberosity occurred.

There were 60 postoperative local AEs. One-quarter of the patients (46 of 187, 25% [95% CI, 19%-31%]) had at least 1 postoperative local AE. Five patients (2.7%, 5 of 187) had severe local events, each requiring another operation, and one of which involved implant revision. Both events resulted from a fall; the baseplate and glenosphere detached in 1 patient, and a periprosthetic fracture occurred in

the other patient. 

An acromial fracture was reported in 3 patients (1.6%; 95% CI, 0.3%- 4.6%).

There were no reports of implant dislocation, infection, or loosening. 

The incidence of scapular notching was 10.6% (95% CI, 6.5%-16%). 

After 2 years, abduction, flexion, and abduction strength improved by 54 (95% CI, 50-58), 57 (95% CI, 53-60), and 5 kg (95% CI, 4-5 kg), respectively (P < .001), whereas external rotation at 0 (1; 95% CI, –1 to 3) did not improve (P . .4). The Constant score improved by 39 (95% CI, 38- 41); Shoulder Pain and Disability Index, by 50 (95% CI, 47-52); and Subjective Shoulder Value, by 43 (95% CI, 41-45) (P < .001).

Comment: This is a thorough review of the short term outcomes for this implant. It is not clear how this prosthesis compares with others.

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