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Delta Reverse Polarity Shoulder Replacement: Single Surgeon Experience with a Minimum 2-Year Follow-up.

Jehan S, Eltayeb M, Javaid MM - Clin Orthop Surg (2015)

Bottom Line: A single surgeon performed all procedures using the anterosuperior approach.The improvement in the Constant score was significant (p < 0.001).At this stage, the results are encouraging with no cases of loosening, dislocation, or nerve injury.

View Article: PubMed Central - PubMed

Affiliation: Department of Trauma and Orthopaedic Surgery, Diana Princess of Wales Hospital, Grimsby, UK.

ABSTRACT

Background: The delta reverse shoulder replacement system was developed for the treatment of rotator cuff arthropathy so that the deltoid can substitute for the deficient rotator cuff. To evaluate the results of delta reverse shoulder replacement for functional improvement and complications in a consecutive series by a single surgeon over a period of six years with a minimum follow-up of 2 years.

Methods: The data were collected retrospectively from electronic theatre records. Over a period of 6 years (2006-2012), 46 cases that fulfilled the inclusion criteria were identified. There were 34 females and 12 males. The average age of patients was 76.2 years (range, 58 to 87 years). A single surgeon performed all procedures using the anterosuperior approach. The mean follow-up time was 49 months (range, 24 to 91 months). All cases had preoperative and postoperative Constant scores. We collected the data on indications, hospital stay, and change in the Constant score, complications, and reoperation rates.

Results: The main indication for surgery was rotator cuff arthropathy (52.2%), followed by massive rotator cuff tear (28.3%), osteoarthritis (8.7%), fractures (6.5%), and rheumatoid arthritis (4.3%). Also, 65.2% of the cases were referred by general practitioners, 26% of the cases were referred by other consultants, and 8.8% of the cases were already under the care of a shoulder surgeon. The average preoperative Constant score was 23.5 (range, 8 to 59). The average Constant score at the final follow-up was 56 (range, 22 to 83). On average, there was an improvement of 33 points in the Constant score. The improvement in the Constant score was significant (p < 0.001). We observed complications in four patients (8.6%). Three of four patients (6.5%) needed reoperation. The first complication was pulmonary embolism in the early postoperative period. The other complications included dissociation of the glenosphere from the metaglene, deltoid detachment, and stitch abscess.

Conclusions: This is a single-surgeon, single-approach series of 46 cases with a minimum follow-up of 2 years. At this stage, the results are encouraging with no cases of loosening, dislocation, or nerve injury.

No MeSH data available.


Related in: MedlinePlus

Indications for surgery.
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Figure 1: Indications for surgery.

Mentions: The demographic data are shown in Table 1. There were 34 females and 12 males. The average age of patients was 76.2 years (range, 58 to 87 years). The proportion of various indications is presented in Fig. 1. The main indication for surgery was rotator cuff arthropathy (52.2%), followed by massive rotator cuff tear (28.3%), osteoarthritis (8.7%), fractures (6.5%), and rheumatoid arthritis (4.3%). Also, 65.2% of the cases were referred by general practitioners, 26% of the cases were referred by other consultants, and 8.8% of the cases were already under the care of a shoulder surgeon. The average duration of hospital stay was 3 days (range, 2 to 7 days). The average preoperative Constant score was 23.5 (range, 8 to 59). The average Constant score at the final follow-up was 56 (range, 22 to 83). On average, there was an improvement of 33 points in the Constant score (Fig. 2). We used the Wilcoxon signed-rank test to assess the change in the Constant score. The improvement in the Constant score was significant (p < 0.001).


Delta Reverse Polarity Shoulder Replacement: Single Surgeon Experience with a Minimum 2-Year Follow-up.

Jehan S, Eltayeb M, Javaid MM - Clin Orthop Surg (2015)

Indications for surgery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4553285&req=5

Figure 1: Indications for surgery.
Mentions: The demographic data are shown in Table 1. There were 34 females and 12 males. The average age of patients was 76.2 years (range, 58 to 87 years). The proportion of various indications is presented in Fig. 1. The main indication for surgery was rotator cuff arthropathy (52.2%), followed by massive rotator cuff tear (28.3%), osteoarthritis (8.7%), fractures (6.5%), and rheumatoid arthritis (4.3%). Also, 65.2% of the cases were referred by general practitioners, 26% of the cases were referred by other consultants, and 8.8% of the cases were already under the care of a shoulder surgeon. The average duration of hospital stay was 3 days (range, 2 to 7 days). The average preoperative Constant score was 23.5 (range, 8 to 59). The average Constant score at the final follow-up was 56 (range, 22 to 83). On average, there was an improvement of 33 points in the Constant score (Fig. 2). We used the Wilcoxon signed-rank test to assess the change in the Constant score. The improvement in the Constant score was significant (p < 0.001).

Bottom Line: A single surgeon performed all procedures using the anterosuperior approach.The improvement in the Constant score was significant (p < 0.001).At this stage, the results are encouraging with no cases of loosening, dislocation, or nerve injury.

View Article: PubMed Central - PubMed

Affiliation: Department of Trauma and Orthopaedic Surgery, Diana Princess of Wales Hospital, Grimsby, UK.

ABSTRACT

Background: The delta reverse shoulder replacement system was developed for the treatment of rotator cuff arthropathy so that the deltoid can substitute for the deficient rotator cuff. To evaluate the results of delta reverse shoulder replacement for functional improvement and complications in a consecutive series by a single surgeon over a period of six years with a minimum follow-up of 2 years.

Methods: The data were collected retrospectively from electronic theatre records. Over a period of 6 years (2006-2012), 46 cases that fulfilled the inclusion criteria were identified. There were 34 females and 12 males. The average age of patients was 76.2 years (range, 58 to 87 years). A single surgeon performed all procedures using the anterosuperior approach. The mean follow-up time was 49 months (range, 24 to 91 months). All cases had preoperative and postoperative Constant scores. We collected the data on indications, hospital stay, and change in the Constant score, complications, and reoperation rates.

Results: The main indication for surgery was rotator cuff arthropathy (52.2%), followed by massive rotator cuff tear (28.3%), osteoarthritis (8.7%), fractures (6.5%), and rheumatoid arthritis (4.3%). Also, 65.2% of the cases were referred by general practitioners, 26% of the cases were referred by other consultants, and 8.8% of the cases were already under the care of a shoulder surgeon. The average preoperative Constant score was 23.5 (range, 8 to 59). The average Constant score at the final follow-up was 56 (range, 22 to 83). On average, there was an improvement of 33 points in the Constant score. The improvement in the Constant score was significant (p < 0.001). We observed complications in four patients (8.6%). Three of four patients (6.5%) needed reoperation. The first complication was pulmonary embolism in the early postoperative period. The other complications included dissociation of the glenosphere from the metaglene, deltoid detachment, and stitch abscess.

Conclusions: This is a single-surgeon, single-approach series of 46 cases with a minimum follow-up of 2 years. At this stage, the results are encouraging with no cases of loosening, dislocation, or nerve injury.

No MeSH data available.


Related in: MedlinePlus