Reverse Shoulder Arthroplasty with a New Convertible Short Stem: Preliminary 2- to 4-year Follow-up Results

Background The Grammont-style reverse shoulder arthroplasty (RSA) has demonstrated complications intrinsic to its design such as tuberosity fracture and scapular notching. A new short-stem press-fit humeral component with an onlay tray has been devised to avert these issues. We hypothesize that the...

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Main Authors: Francesco Ascione MD, Giulia Bugelli MD, Peter Domos MD, FRCS, Lionel Neyton MD, Arnaud Godeneche MD, Michael J Bercik MD, Gilles Walch MD
Format: Article
Language:English
Published: SAGE Publishing 2017-12-01
Series:Journal of Shoulder and Elbow Arthroplasty
Online Access:https://doi.org/10.1177/2471549217746272
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spelling doaj-ecabd4a2627244eea839eab34501059c2020-11-25T02:54:34ZengSAGE PublishingJournal of Shoulder and Elbow Arthroplasty2471-54922017-12-01110.1177/2471549217746272Reverse Shoulder Arthroplasty with a New Convertible Short Stem: Preliminary 2- to 4-year Follow-up ResultsFrancesco Ascione MD0Giulia Bugelli MD1Peter Domos MD, FRCS2Lionel Neyton MD3Arnaud Godeneche MD4Michael J Bercik MD5Gilles Walch MD6Shoulder Surgery Division, Campolongo Hospital, Salerno, ItalyCentre Orthopédique Santy, , Ramsay Générale de Santé, Lyon, FranceCentre Orthopédique Santy, , Ramsay Générale de Santé, Lyon, FranceCentre Orthopédique Santy, , Ramsay Générale de Santé, Lyon, FranceCentre Orthopédique Santy, , Ramsay Générale de Santé, Lyon, FranceCentre Orthopédique Santy, , Ramsay Générale de Santé, Lyon, FranceCentre Orthopédique Santy, , Ramsay Générale de Santé, Lyon, FranceBackground The Grammont-style reverse shoulder arthroplasty (RSA) has demonstrated complications intrinsic to its design such as tuberosity fracture and scapular notching. A new short-stem press-fit humeral component with an onlay tray has been devised to avert these issues. We hypothesize that the clinical outcomes and rates of humeral complications of this new stem will be comparable to those of the traditional Grammont design and the lateralization obtained from the stem’s lower neck-shaft angle will decrease the rate of notching without creating instability. Methods We retrospectively evaluated 100 patients who underwent RSA with an onlay short-stem humeral component with a minimum follow-up of 2 years. Clinical outcomes as well as standard radiological examinations were documented pre- and postoperatively. Several correlations were analyzed. Results At mean 32.6-month follow-up, the cohort demonstrated a significant improvement in several outcomes: Constant score increased from 25.5 to 69.7 points, mean anterior elevation increased from 82.1° to 141.9°, external rotation from 5.6° to 25.1°, and internal rotation from sacrum to the L3 vertebral level. There was a 30% rate of stem malalignment and 37% rate of scapular notching, not associated with any adverse clinical outcomes. The overall rate of complications was 15%, of which scapular fractures were most common (5%). Conclusion Our short-term results suggest that the clinical outcomes and rates of humeral complications are similar to those reported for the Grammont RSA, demonstrating less scapular notching, but increased scapular stress fractures and potential subsidence of the prosthesis due to the metaphyseal press-fit require further investigations.https://doi.org/10.1177/2471549217746272
collection DOAJ
language English
format Article
sources DOAJ
author Francesco Ascione MD
Giulia Bugelli MD
Peter Domos MD, FRCS
Lionel Neyton MD
Arnaud Godeneche MD
Michael J Bercik MD
Gilles Walch MD
spellingShingle Francesco Ascione MD
Giulia Bugelli MD
Peter Domos MD, FRCS
Lionel Neyton MD
Arnaud Godeneche MD
Michael J Bercik MD
Gilles Walch MD
Reverse Shoulder Arthroplasty with a New Convertible Short Stem: Preliminary 2- to 4-year Follow-up Results
Journal of Shoulder and Elbow Arthroplasty
author_facet Francesco Ascione MD
Giulia Bugelli MD
Peter Domos MD, FRCS
Lionel Neyton MD
Arnaud Godeneche MD
Michael J Bercik MD
Gilles Walch MD
author_sort Francesco Ascione MD
title Reverse Shoulder Arthroplasty with a New Convertible Short Stem: Preliminary 2- to 4-year Follow-up Results
title_short Reverse Shoulder Arthroplasty with a New Convertible Short Stem: Preliminary 2- to 4-year Follow-up Results
title_full Reverse Shoulder Arthroplasty with a New Convertible Short Stem: Preliminary 2- to 4-year Follow-up Results
title_fullStr Reverse Shoulder Arthroplasty with a New Convertible Short Stem: Preliminary 2- to 4-year Follow-up Results
title_full_unstemmed Reverse Shoulder Arthroplasty with a New Convertible Short Stem: Preliminary 2- to 4-year Follow-up Results
title_sort reverse shoulder arthroplasty with a new convertible short stem: preliminary 2- to 4-year follow-up results
publisher SAGE Publishing
series Journal of Shoulder and Elbow Arthroplasty
issn 2471-5492
publishDate 2017-12-01
description Background The Grammont-style reverse shoulder arthroplasty (RSA) has demonstrated complications intrinsic to its design such as tuberosity fracture and scapular notching. A new short-stem press-fit humeral component with an onlay tray has been devised to avert these issues. We hypothesize that the clinical outcomes and rates of humeral complications of this new stem will be comparable to those of the traditional Grammont design and the lateralization obtained from the stem’s lower neck-shaft angle will decrease the rate of notching without creating instability. Methods We retrospectively evaluated 100 patients who underwent RSA with an onlay short-stem humeral component with a minimum follow-up of 2 years. Clinical outcomes as well as standard radiological examinations were documented pre- and postoperatively. Several correlations were analyzed. Results At mean 32.6-month follow-up, the cohort demonstrated a significant improvement in several outcomes: Constant score increased from 25.5 to 69.7 points, mean anterior elevation increased from 82.1° to 141.9°, external rotation from 5.6° to 25.1°, and internal rotation from sacrum to the L3 vertebral level. There was a 30% rate of stem malalignment and 37% rate of scapular notching, not associated with any adverse clinical outcomes. The overall rate of complications was 15%, of which scapular fractures were most common (5%). Conclusion Our short-term results suggest that the clinical outcomes and rates of humeral complications are similar to those reported for the Grammont RSA, demonstrating less scapular notching, but increased scapular stress fractures and potential subsidence of the prosthesis due to the metaphyseal press-fit require further investigations.
url https://doi.org/10.1177/2471549217746272
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