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Reverse shoulder arthroplasty. Part 1: Systematic review of clinical and functional outcomes.

Samitier G, Alentorn-Geli E, Torrens C, Wright TW - Int J Shoulder Surg (2015 Jan-Mar)

Bottom Line: Many factors influence the outcomes of reverse shoulder arthroplasty (RSA).Indications of RSA for cuff tear arthropathy demonstrated higher improvements in the outcomes compared with other indications.Level IV.

View Article: PubMed Central - PubMed

Affiliation: Orthopaedics and Sports Medicine Institute, Department of Orthopaedics & Rehabilitation, University of Florida, Gainesville, Florida, USA.

ABSTRACT

Unlabelled: Many factors influence the outcomes of reverse shoulder arthroplasty (RSA). The purpose of this study was to compare the clinical and functional outcomes of RSA depending on the surgical approach, type of prosthesis, and indication for surgery through a comprehensive, systematic review. A literature search was conducted (1985 to June 2012) using PubMed, CINAHL, EBSCO-SPORTDiscus, and Cochrane Central Register of Controlled Trials. Levels I-IV evidence, in-vivo human studies (written in English with minimum of 2 years of follow-up and sample size of 10 patients) reporting clinical and/or functional outcomes after RSA were included. The outcomes were analyzed depending on the surgical approach, type of prosthesis (with medialized or lateralized center of rotation), or indication for surgery. A total of 35 studies were included involving 2049 patients (mean [SD] percentage of females, age, and follow-up of 71.6% [13.4], 71.5 years [3.7], and 43.1 months [18.8], respectively). Studies using deltopectoral approach with lateralized prostheses demonstrated greater improvement in external rotation compared with medialized prostheses with the same approach (mean 22.9° and 5°, respectively). In general, RSA for cuff tear arthropathy demonstrated higher improvements in Constant and American Shoulder and Elbow Society scores, and range of motion compared with revision of anatomic prosthesis, failed rotator cuff repair, and fracture sequelae. Lateralized prostheses provided more improvement in external rotation compared to medialized prostheses. Indications of RSA for cuff tear arthropathy demonstrated higher improvements in the outcomes compared with other indications. RSA demonstrated high patient's satisfaction regardless of the type of prosthesis or indication for surgery.

Level of evidence: Level IV.

No MeSH data available.


Related in: MedlinePlus

Literature search flow chart
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Figure 1: Literature search flow chart

Mentions: The PubMed search yielded 329 citations, from which 174 were clinical studies in humans that were reviewed in further detail. About 32 met inclusion criteria and additional database searches and review of the reference list from included articles yielded a final number of 35 articles included in the descriptive analysis of clinical outcomes [Figure 1].[510111718202122232425262728293031323334353637383940414243444546] From all 174 articles assessed for eligibility, the senior author had to review four of them because of disagreement between the two authors conducting the systematic review. These two authors had no disagreement on data extraction for the 35 included studies.


Reverse shoulder arthroplasty. Part 1: Systematic review of clinical and functional outcomes.

Samitier G, Alentorn-Geli E, Torrens C, Wright TW - Int J Shoulder Surg (2015 Jan-Mar)

Literature search flow chart
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325387&req=5

Figure 1: Literature search flow chart
Mentions: The PubMed search yielded 329 citations, from which 174 were clinical studies in humans that were reviewed in further detail. About 32 met inclusion criteria and additional database searches and review of the reference list from included articles yielded a final number of 35 articles included in the descriptive analysis of clinical outcomes [Figure 1].[510111718202122232425262728293031323334353637383940414243444546] From all 174 articles assessed for eligibility, the senior author had to review four of them because of disagreement between the two authors conducting the systematic review. These two authors had no disagreement on data extraction for the 35 included studies.

Bottom Line: Many factors influence the outcomes of reverse shoulder arthroplasty (RSA).Indications of RSA for cuff tear arthropathy demonstrated higher improvements in the outcomes compared with other indications.Level IV.

View Article: PubMed Central - PubMed

Affiliation: Orthopaedics and Sports Medicine Institute, Department of Orthopaedics & Rehabilitation, University of Florida, Gainesville, Florida, USA.

ABSTRACT

Unlabelled: Many factors influence the outcomes of reverse shoulder arthroplasty (RSA). The purpose of this study was to compare the clinical and functional outcomes of RSA depending on the surgical approach, type of prosthesis, and indication for surgery through a comprehensive, systematic review. A literature search was conducted (1985 to June 2012) using PubMed, CINAHL, EBSCO-SPORTDiscus, and Cochrane Central Register of Controlled Trials. Levels I-IV evidence, in-vivo human studies (written in English with minimum of 2 years of follow-up and sample size of 10 patients) reporting clinical and/or functional outcomes after RSA were included. The outcomes were analyzed depending on the surgical approach, type of prosthesis (with medialized or lateralized center of rotation), or indication for surgery. A total of 35 studies were included involving 2049 patients (mean [SD] percentage of females, age, and follow-up of 71.6% [13.4], 71.5 years [3.7], and 43.1 months [18.8], respectively). Studies using deltopectoral approach with lateralized prostheses demonstrated greater improvement in external rotation compared with medialized prostheses with the same approach (mean 22.9° and 5°, respectively). In general, RSA for cuff tear arthropathy demonstrated higher improvements in Constant and American Shoulder and Elbow Society scores, and range of motion compared with revision of anatomic prosthesis, failed rotator cuff repair, and fracture sequelae. Lateralized prostheses provided more improvement in external rotation compared to medialized prostheses. Indications of RSA for cuff tear arthropathy demonstrated higher improvements in the outcomes compared with other indications. RSA demonstrated high patient's satisfaction regardless of the type of prosthesis or indication for surgery.

Level of evidence: Level IV.

No MeSH data available.


Related in: MedlinePlus