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Revision to reverse shoulder arthroplasty with retention of the humeral component.

Werner BS, Boehm D, Gohlke F - Acta Orthop (2013)

Bottom Line: Mean Constant score improved from 9 (2-16) to 41 (17-74) points.Modular systems allow retainment of a well-fixed humeral stem with good outcome.There is a risk of excessive humeral lengthening.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics and Trauma Surgery , Franziskus-Hospital Harderberg , Georgsmarienhütte.

ABSTRACT

Background: Revision in failed shoulder arthroplasty often requires removal of the humeral component with a significant risk of fracture and bone loss. Newer modular systems allow conversion from anatomic to reverse shoulder arthroplasty with retention of a well-fixed humeral stem. We report on a prospectively evaluated series of conversions from hemiarthroplasty to reverse shoulder arthroplasty.

Methods: In 14 cases of failed hemiarthroplasty due to rotator cuff deficiency and painful pseudoparalysis (in 13 women), revision to reverse shoulder arthroplasty was performed between October 2006 and 2010, with retention of the humeral component using modular systems. Mean age at the time of operation was 70 (56-80) years. Pre- and postoperative evaluation followed a standardized protocol including Constant score, range of motion, and radiographic analysis. Mean follow-up time was 2.5 (2-5.5) years.

Results: Mean Constant score improved from 9 (2-16) to 41 (17-74) points. Mean lengthening of the arm was 2.6 (0.9-4.7) cm without any neurological complications. One patient required revision due to infection.

Interpretation: Modular systems allow retainment of a well-fixed humeral stem with good outcome. There is a risk of excessive humeral lengthening.

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Related in: MedlinePlus

Measurement of lengthening of the arm was performed preoperatively (panel A) and postoperatively (panel B) on true anteroposterior radiographs. Measurement was corrected for humeral abduction and magnification. CH: connecting point between metaphyseal and diaphyseal humeral components; TH: distal tip of the humeral component; ACH: distance between the inferolateral tip of the acromion and point CH.
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Figure 1: Measurement of lengthening of the arm was performed preoperatively (panel A) and postoperatively (panel B) on true anteroposterior radiographs. Measurement was corrected for humeral abduction and magnification. CH: connecting point between metaphyseal and diaphyseal humeral components; TH: distal tip of the humeral component; ACH: distance between the inferolateral tip of the acromion and point CH.


Revision to reverse shoulder arthroplasty with retention of the humeral component.

Werner BS, Boehm D, Gohlke F - Acta Orthop (2013)

Measurement of lengthening of the arm was performed preoperatively (panel A) and postoperatively (panel B) on true anteroposterior radiographs. Measurement was corrected for humeral abduction and magnification. CH: connecting point between metaphyseal and diaphyseal humeral components; TH: distal tip of the humeral component; ACH: distance between the inferolateral tip of the acromion and point CH.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3822132&req=5

Figure 1: Measurement of lengthening of the arm was performed preoperatively (panel A) and postoperatively (panel B) on true anteroposterior radiographs. Measurement was corrected for humeral abduction and magnification. CH: connecting point between metaphyseal and diaphyseal humeral components; TH: distal tip of the humeral component; ACH: distance between the inferolateral tip of the acromion and point CH.
Bottom Line: Mean Constant score improved from 9 (2-16) to 41 (17-74) points.Modular systems allow retainment of a well-fixed humeral stem with good outcome.There is a risk of excessive humeral lengthening.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics and Trauma Surgery , Franziskus-Hospital Harderberg , Georgsmarienhütte.

ABSTRACT

Background: Revision in failed shoulder arthroplasty often requires removal of the humeral component with a significant risk of fracture and bone loss. Newer modular systems allow conversion from anatomic to reverse shoulder arthroplasty with retention of a well-fixed humeral stem. We report on a prospectively evaluated series of conversions from hemiarthroplasty to reverse shoulder arthroplasty.

Methods: In 14 cases of failed hemiarthroplasty due to rotator cuff deficiency and painful pseudoparalysis (in 13 women), revision to reverse shoulder arthroplasty was performed between October 2006 and 2010, with retention of the humeral component using modular systems. Mean age at the time of operation was 70 (56-80) years. Pre- and postoperative evaluation followed a standardized protocol including Constant score, range of motion, and radiographic analysis. Mean follow-up time was 2.5 (2-5.5) years.

Results: Mean Constant score improved from 9 (2-16) to 41 (17-74) points. Mean lengthening of the arm was 2.6 (0.9-4.7) cm without any neurological complications. One patient required revision due to infection.

Interpretation: Modular systems allow retainment of a well-fixed humeral stem with good outcome. There is a risk of excessive humeral lengthening.

Show MeSH
Related in: MedlinePlus