Subsidence of Uncemented Short Stems in Reverse Shoulder Arthroplasty—A Multicenter Study
Abstract
:1. Introduction
2. Experimental Section
2.1. Implant
2.2. Surgical Technique
2.3. Clinical Analysis
2.4. Radiographic Analysis
2.5. Statistics
3. Results
3.1. Clinical Results
3.2. Complications
3.3. Radiological Outcome
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Demographics and Characteristics | |
---|---|
Shoulders, n | 143 |
Age (Years) | 73 (SD ± 9) |
Gender, Female/Male n (%) | 87 (63)/52 (37) |
Primary Osteoarthritis, n (%) | 62 (43) |
Cuff Tear Arthropathy, n (%) | 41 (29) |
Massive Rotator Cuff Tears, n (%) | 36 (25) |
Rheumatoid Arthritis, n (%) | 2 (1) |
Posttraumatic Arthritis, n (%) | 2 (1) |
Uncemented RSA, n (%) | 143 (100) |
Bio-RSA, n (%) | 92 (64) |
Radiological Follow-Up (Months) | 18 (SD ± 8) |
Clinical Follow-Up (Months) | 17 (SD ± 7) |
Preoperative | At Follow-Up | p-Value | |
---|---|---|---|
SSV (%) | 37.0 (SD ± 19.5) | 80.3 (SD ± 16.5 | p < 0.001 * |
CS (Points) | 34.3 (SD ± 18.0) | 72.2 (SD ± 13.4) | p < 0.001 * |
Activity (Points) | 8.6 (SD ± 4.1) | 16.6 (SD ± 3.4) | p < 0.001 * |
Mobility (Points) | 19.0 (SD ± 10.1) | 30.9 (SD ± 6.4) | p < 0.001 * |
Strength (Points) | 3.3 (SD ± 4.4) | 11.1 (SD ± 5.9) | p < 0.001 * |
Pain (Points) | 7.3 (SD ± 4.6) | 28.6 (SD ± 26.2) | p < 0.001 * |
Flexion (Degree) | 108.4 (SD ± 49.3) | 144.0 (SD ± 23.4) | p < 0.001 * |
External Rotation (Degree) | 25.8(SD ± 25.2) | 36.7 (SD ± 21.6) | p < 0.001 * |
Complications | Frequency | Time until Complication | Revision Surgery |
---|---|---|---|
Postoperative Hematoma | 1 | 7 Days | Removal of Hematoma |
Periprosthetic Fracture | 2 | 3 Months 5 Months | Plate Osteosynthesis Non-Operative |
Dislocation | 1 | 1 Month | Short Stem Removal, Long Stem Implantation |
Infection | 1 | 16 Months | Short Stem Removal, Spacer Implantation |
Neoplasia Under the Stem | 1 | 1 Month | Short Stem Removal, Long Stem Implantation |
Radiological Outcome | |
---|---|
Subsidence (mm) | 1.4 (SD ± 3.7) |
Subsidence >15 mm, n (%) | 15 (11) |
Metaphyseal FR | 0.61 (SD ± 0.12) |
Diaphyseal FR | 0.70 (SD ± 0.11) |
Cortical Width Metaphyseal (mm) Postoperative | 3.6 (SD ± 1.5) |
Cortical Width Diaphyseal (mm) Postoperative | 5.4 (SD ± 1.3) |
Shaft Inclination Postoperative | 99 Neutral (72%), 29 Valgus (21%), 9 Varus (7%) |
Shaft Inclination at Final FU | 97 Neutral (71%), 29 Valgus (21%), 11 Varus (8%) |
Subsidence < 5 mm | Subsidence > 5 mm | p-Value | |
---|---|---|---|
Age (years) | 72.71 (SD ± 8.86) | 76.8 (SD ± 7.03) | 0.164 * |
SSV at FU (%) | 80.24 (SD ± 17.32) | 80.71(SD ± 7.87) | 0.527 * |
CS at FU (Points) | 72.31 (SD ± 13.38) | 71.19 (SD ± 13.57) | 0.456 * |
Activity at FU (Points) | 16.51 (SD ± 3.54) | 17.29 (SD ± 2.33) | 0.634 * |
Mobility at FU (Points) | 31.06 (SD ± 6.14) | 29.67(SD ± 8.04) | 0.658 * |
Strength at FU (Points) | 11.53 (SD ± 5.77) | 8.33 (SD ± 6.39) | 0.022 * |
Pain at FU (Points) | 29.85 (SD ± 26.75) | 19.19 (SD ± 19.66) | 0.189 * |
Flexion at FU (Degree) | 144.72 (SD ± 23.3) | 138.33 (SD ± 24.62) | 0.231 * |
Extension at FU (Degree) | 36.81 (SD ± 22.28) | 36.67 (SD ± 16.76) | 0.960 * |
Diaphyseal FR | 0.69 (SD ± 0.11) | 0.71 (SD ± 0.09) | 0.603 * |
Metaphyseal FR | 0.61 (SD ± 0.12) | 0.64 (SD ± 0.13) | 0.484 ** |
Metaphyseal Cortical Width (mm) | 3.61 (SD ± 1.43) | 3.40 (SD ± 1.76) | 0.480 * |
Diaphyseal Cortical Width (mm) | 5.47 (SD ± 1.27) | 5.33 (SD ± 1.45) | 0.476 * |
Inclination FU (Degree) | 5.26 (SD ± 10.03) | 4.17 (SD ± 4.89) | 0.348 * |
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Tross, A.-K.; Lädermann, A.; Wittmann, T.; Schnetzke, M.; Nolte, P.-C.; Collin, P.; Raiss, P. Subsidence of Uncemented Short Stems in Reverse Shoulder Arthroplasty—A Multicenter Study. J. Clin. Med. 2020, 9, 3362. https://doi.org/10.3390/jcm9103362
Tross A-K, Lädermann A, Wittmann T, Schnetzke M, Nolte P-C, Collin P, Raiss P. Subsidence of Uncemented Short Stems in Reverse Shoulder Arthroplasty—A Multicenter Study. Journal of Clinical Medicine. 2020; 9(10):3362. https://doi.org/10.3390/jcm9103362
Chicago/Turabian StyleTross, Anna-K., Alexandre Lädermann, Thomas Wittmann, Marc Schnetzke, Philip-C. Nolte, Philippe Collin, and Patric Raiss. 2020. "Subsidence of Uncemented Short Stems in Reverse Shoulder Arthroplasty—A Multicenter Study" Journal of Clinical Medicine 9, no. 10: 3362. https://doi.org/10.3390/jcm9103362
APA StyleTross, A. -K., Lädermann, A., Wittmann, T., Schnetzke, M., Nolte, P. -C., Collin, P., & Raiss, P. (2020). Subsidence of Uncemented Short Stems in Reverse Shoulder Arthroplasty—A Multicenter Study. Journal of Clinical Medicine, 9(10), 3362. https://doi.org/10.3390/jcm9103362