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Published in: International Orthopaedics 6/2014

01-06-2014 | Original Paper

Reverse shoulder arthroplasty with a short metaphyseal humeral stem

Authors: Ehud Atoun, Alexander Van Tongel, Nir Hous, Ali Narvani, Jai Relwani, Ruben Abraham, Ofer Levy

Published in: International Orthopaedics | Issue 6/2014

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Abstract

Purpose

Reverse shoulder prostheses have been gaining popularity in recent years. A short metaphyseal stem design will allow bone stock preservation and minimize stem related complications. We examined the clinical and radiographic short-term outcome of a short metaphyseal stem reverse shoulder arthroplasty.

Methods

Thirty-one patients, with a mean follow-up of 36 months (24–52), were evaluated clinically with the Constant-Murley score, patient satisfaction and pain relief scores. The fixation of the glenoid and humeral components, subsidence and notching were evaluated on radiographs. The indications were cuff tear arthropathy (22), fracture sequelae (five) and rheumatoid arthritis (four).

Results

The average Constant score improved from 12.7 (range two to 31) pre-operatively to 56.2 (range 17–86) postoperatively. It rose from 13.5 to 58.3 in patients with Cuff arthropathy, from 15.8 to 62.0 in revision arthroplasty, from 10.2 to 47.4 in those with fracture sequelae, and from 11.5 to 55.3 in patients with rheumatoid arthritis. The overall mean patient satisfaction score improved from 2.4/10 to 8.5/10 and mean pain score improved from 0.8/15 to 12.5/15. We found an overall improvement in active forward flexion from 46.8 to 128.5° and from 41.6 to 116.5° in abduction. No humeral loosening or subsidence was observed. Two cases of grade 1–2 glenoid notching were reported. Overall there were three intra-operative fractures that did not affect the operation and healed without affecting the good results. There were five late traumatic periprosthetic fractures, only one of them required a revision surgery to a stemmed implant and the rest healed without surgery. There were two early dislocations that had to be revised.

Conclusions

The clinical and radiographic evaluation of a bone preserving metaphyseal humeral component in reverse shoulder arthroplasty is promising, with good clinical results, no signs of loosening or subsidence.
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Metadata
Title
Reverse shoulder arthroplasty with a short metaphyseal humeral stem
Authors
Ehud Atoun
Alexander Van Tongel
Nir Hous
Ali Narvani
Jai Relwani
Ruben Abraham
Ofer Levy
Publication date
01-06-2014
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 6/2014
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-014-2328-8

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