Acromial spine fracture after reverse total shoulder arthroplasty: a systematic review
These authors performed a systematic review of the literature to analyze the occurrence and outcomes of acromial and spine fractures after reverse total shoulder (RSA).
Among 3838 RSAs, 159 acromial fractures were reported, for an overall incidence of 4.14%; the mean time to diagnosis from surgery was 9 months (range, 1.3-24 months).
These authors performed a systematic review of the literature to analyze the occurrence and outcomes of acromial and spine fractures after reverse total shoulder (RSA).
Among 3838 RSAs, 159 acromial fractures were reported, for an overall incidence of 4.14%; the mean time to diagnosis from surgery was 9 months (range, 1.3-24 months).
Regardless of treatment, patients reported inferior function after fracture compared with their function immediately after RSA.
Forward flexion was 95° (range, 30°-110°), abduction was 76° (range, 30°-180°), the Constant score was 63 (range, 59-67.5), and the American Shoulder and Elbow Surgeons score was 57 (range, 7-83); all values were reduced compared with patients without fractures.
This study suggests the occurrence of acromial fractures after RSA is a common event, with a rate of over 4%. These fractures correlate with worse postoperative outcomes regardless of treatment method; open reduction–internal fixation was not shown to be clinically superior despite a limited complication rate.
This study suggests the occurrence of acromial fractures after RSA is a common event, with a rate of over 4%. These fractures correlate with worse postoperative outcomes regardless of treatment method; open reduction–internal fixation was not shown to be clinically superior despite a limited complication rate.
Comment: This article points to the frequency of this complication, which is not seen with other types of shoulder arthroplasty. It does not, however, discuss the factors other than osteoporosis that may contribute to acromial and spine fractures, such as over lengthening, screw placement, and activity level. For more information see this link, this link, and this link.
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