PubTransformer

A site to transform Pubmed publications into these bibliographic reference formats: ADS, BibTeX, EndNote, ISI used by the Web of Knowledge, RIS, MEDLINE, Microsoft's Word 2007 XML.

Five-year outcome after conversion of a hemiarthroplasty when used for the treatment of a proximal humeral fracture to a reverse total shoulder arthroplasty.

Abstract Aims The reasons for failure of a hemirthroplasty (HA) when used to treat a proximal humeral fracture include displaced or necrotic tuberosities, insufficient metaphyseal bone-stock, and rotator cuff tears. Reverse total shoulder arthroplasty (rTSA) is often the only remaining form of treatment in these patients. The aim of this study was to evaluate the clinical outcome after conversions from a failed HA to rTSA. Material and Methods A total of 35 patients, in whom a HA, as treatment for a fracture of the proximal humerus, had failed, underwent conversion to a rTSA. A total of 28 were available for follow-up at a mean of 61 months (37 to 91), having been initially reviewed at a mean of 20 months (12 to 36) postoperatively. Having a convertible design, the humeral stem could be preserved in nine patients. The stem was removed in the other 19 patients and a conventional rTSA was implanted. At final follow-up, patients were assessed using the American Shoulder and Elbow Surgeons (ASES) score, the Constant Score, and plain radiographs. Results At final follow-up, the mean ASES was 59 (25 to 97) and the mean adjusted Constant Score was 63% (23% to 109%). Both improved significantly (p < 0.001). The mean forward flexion was 104° (50° to 155°) and mean abduction was 98° (60° to 140°). Nine patients (32%) had a complication; two had an infection and instability, respectively; three had a scapular fracture; and one patient each had delayed wound healing and symptomatic loosening. If implants could be converted to a rTSA without removal of the stem, the operating time was shorter (82 minutes versus 102 minutes; p = 0.018). Conclusion After failure of a HA in the treatment of a proximal humeral fracture, conversion to a rTSA may achieve pain relief and improved shoulder function. The complication rate is considerable. Cite this article: Bone Joint J 2018;100-B:761-6.
PMID
Related Publications

The effect of proximal humeral bone loss on revision reverse total shoulder arthroplasty.

Allograft-Prosthetic Composite Reconstruction for Massive Proximal Humeral Bone Loss in Reverse Shoulder Arthroplasty.

Reverse shoulder arthroplasty for proximal humeral fractures: outcomes comparing primary reverse arthroplasty for fracture versus reverse arthroplasty after failed osteosynthesis.

Early clinical and radiological outcomes of reverse shoulder arthroplasty with an eccentric all-polyethylene glenosphere to treat failed hemiarthroplasty and the sequelae of proximal humeral fractures.

Outcomes of reverse total shoulder arthroplasty as primary versus revision procedure for proximal humerus fractures.

Authors

Mayor MeshTerms
Keywords

Convertible implant

Failed shoulder arthroplasty

Hemiarthroplasty

Metaphyseal bone loss

Reverse total shoulder arthroplasty

Revision shoulder arthroplasty

Tuberosity nonunion

Journal Title the bone & joint journal
Publication Year Start




PMID- 29855243
OWN - NLM
STAT- MEDLINE
DCOM- 20180612
LR  - 20180612
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 100-B
IP  - 6
DP  - 2018 Jun 1
TI  - Five-year outcome after conversion of a hemiarthroplasty when used for the
      treatment of a proximal humeral fracture to a reverse total shoulder
      arthroplasty.
PG  - 761-766
LID - 10.1302/0301-620X.100B6.BJJ-2017-1280.R1 [doi]
AB  - Aims The reasons for failure of a hemirthroplasty (HA) when used to treat a
      proximal humeral fracture include displaced or necrotic tuberosities,
      insufficient metaphyseal bone-stock, and rotator cuff tears. Reverse total
      shoulder arthroplasty (rTSA) is often the only remaining form of treatment in
      these patients. The aim of this study was to evaluate the clinical outcome after 
      conversions from a failed HA to rTSA. Material and Methods A total of 35
      patients, in whom a HA, as treatment for a fracture of the proximal humerus, had 
      failed, underwent conversion to a rTSA. A total of 28 were available for
      follow-up at a mean of 61 months (37 to 91), having been initially reviewed at a 
      mean of 20 months (12 to 36) postoperatively. Having a convertible design, the
      humeral stem could be preserved in nine patients. The stem was removed in the
      other 19 patients and a conventional rTSA was implanted. At final follow-up,
      patients were assessed using the American Shoulder and Elbow Surgeons (ASES)
      score, the Constant Score, and plain radiographs. Results At final follow-up, the
      mean ASES was 59 (25 to 97) and the mean adjusted Constant Score was 63% (23% to 
      109%). Both improved significantly (p &lt; 0.001). The mean forward flexion was 104 
      degrees (50 degrees to 155 degrees ) and mean abduction was 98 degrees (60
      degrees to 140 degrees ). Nine patients (32%) had a complication; two had an
      infection and instability, respectively; three had a scapular fracture; and one
      patient each had delayed wound healing and symptomatic loosening. If implants
      could be converted to a rTSA without removal of the stem, the operating time was 
      shorter (82 minutes versus 102 minutes; p = 0.018). Conclusion After failure of a
      HA in the treatment of a proximal humeral fracture, conversion to a rTSA may
      achieve pain relief and improved shoulder function. The complication rate is
      considerable. Cite this article: Bone Joint J 2018;100-B:761-6.
FAU - Holschen, M
AU  - Holschen M
AD  - Orthopedic Practice Clinic (OPPK) and Raphaelsklinik Munster, Munster, Germany.
FAU - Siemes, M-K
AU  - Siemes MK
AD  - Orthopedic Practice Clinic (OPPK), Munster, Germany.
FAU - Witt, K-A
AU  - Witt KA
AD  - Orthopedic Practice Clinic (OPPK), Munster, Germany.
FAU - Steinbeck, J
AU  - Steinbeck J
AD  - Orthopedic Practice Clinic (OPPK), Munster, Germany.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Bone Joint J
JT  - The bone &amp; joint journal
JID - 101599229
SB  - AIM
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Arthroplasty, Replacement, Shoulder/adverse effects/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Hemiarthroplasty/*adverse effects/methods
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/epidemiology
MH  - Range of Motion, Articular
MH  - Reoperation/adverse effects/*methods
MH  - Shoulder Fractures/*surgery
MH  - Shoulder Joint/surgery
MH  - Shoulder Prosthesis/*adverse effects
MH  - Treatment Failure
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Convertible implant
OT  - Failed shoulder arthroplasty
OT  - Hemiarthroplasty
OT  - Metaphyseal bone loss
OT  - Reverse total shoulder arthroplasty
OT  - Revision shoulder arthroplasty
OT  - Tuberosity nonunion
EDAT- 2018/06/02 06:00
MHDA- 2018/06/13 06:00
CRDT- 2018/06/02 06:00
PHST- 2018/06/02 06:00 [entrez]
PHST- 2018/06/02 06:00 [pubmed]
PHST- 2018/06/13 06:00 [medline]
AID - 10.1302/0301-620X.100B6.BJJ-2017-1280.R1 [doi]
PST - ppublish
SO  - Bone Joint J. 2018 Jun 1;100-B(6):761-766. doi:
      10.1302/0301-620X.100B6.BJJ-2017-1280.R1.