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International Orthopaedics
Published in: International Orthopaedics 7/2013

01-07-2013 | Original Paper

Conversion of shoulder arthroplasty to reverse implants: clinical and radiological results using a modular system

Authors: Alessandro Castagna, Marco Delcogliano, Francesca de Caro, Giovanni Ziveri, Mario Borroni, Stefano Gumina, Franco Postacchini, Carlo Felice De Biase

Published in: International Orthopaedics | Issue 7/2013

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Abstract

Purpose

Revision of a shoulder arthroplasty to a reverse arthroplasty is a highly demanding procedure. The aim of this study is to report the clinical results of hemi and total shoulder prosthesis revisions to reverse implants without removal of the humeral stem, using a modular shoulder replacement system (SMR Lima LTD). We retrospectively reviewed 26 patients who underwent an operation from 2004 to 2009.

Methods

The patients were divided into two groups: in Group I, 18 patients underwent a revision of hemiarthroplasty implanted for fracture; in Group II, eight patients underwent a revision of anatomical total prosthesis. All patients were evaluated at a mean follow-up of 32.3 (±12.7) months using the Constant score rating scale and by range of motion evaluation, EQ-VAS, X-ray and CT scan.

Results

The Constant score of each patient was 47.88 (±5.88) after the revision. The EQ-VAS improved from 40 (±20) to 70 (±10). All patients improved in terms of range of motion. The radiographs and CT scans obtained after revision showed good integration and no signs of loosening of the implant. The mean time of surgery was recorded as 62′ (±8′), with a maximum blood loss of less than 300 ml in all cases.

Conclusions

Our study demonstrates that using a full modular system at the time of the first implant allows avoidance of the step to remove the humeral stem and metal back in cases of shoulder prosthesis revision to a reverse prosthesis, resulting in a short operative time, few intraoperative complications and a satisfactory clinical outcome at medium-term follow-up.
Literature
1.
2.
3.
4.
5.
6.
Kumar S, Sperling JW, Haidukewych GH, Cofield RH (2004) Periprosthetic humeral fractures after shoulder arthroplasty. J Bone Joint Surg Am 86:680–689PubMed
7.
8.
Sanchez-Sotelo J, Sperling JW, Rowland CM, Cofield RH (2003) Instability after shoulder arthroplasty: results of surgical treatment. J Bone Joint Surg Am 85:622–631PubMedCrossRef
9.
Sperling JW, Antuna SA, Sanchez-Sotelo J, Schleck C, Cofield RH (2002) Shoulder arthroplasty for arthritis after instability surgery. J Bone Joint Surg Am 84:1775–1781PubMed
10.
Sperling JW, Cofield RH, Rowland CM (2004) Minimum fifteen-year follow-up of Neer hemiarthroplasty and total shoulder arthroplasty in patients aged fifty years or younger. J Should Elb Surg 13:604–613CrossRef
11.
Torchia ME, Cofield RH, Settergren CR (1997) Total shoulder arthroplasty with the Neer prosthesis: long-term results. J Should Elb Surg 6:495–505CrossRef
12.
13.
Boileau P, Krishnan SG, Tinsi L, Walch G, Coste JS, Mole D (2002) Tuberosity malposition and migration: reasons for poor outcomes after hemiarthroplasty for displaced fractures of the proximal humerus. J Should Elb Surg 11:401–412CrossRef
14.
Boileau P, Trojani C, Walch G, Krishnan SG, Romeo A, Sinnerton R (2001) Shoulder arthroplasty for the treatment of the sequelae of fractures of the proximal humerus. J Should Elb Surg 10:299–308CrossRef
15.
Goldman RT, Koval KJ, Cuomo F, Gallagher MA, Zuckerman JD (1995) Functional outcome after humeral head replacement for acute three- and four-part proximal humeral fractures. J Should Elb Surg 4:81–86CrossRef
16.
Green A, Barnard WL, Limbird RS (1993) Humeral head replacement for acute, four- part proximal humerus fractures. J Should Elb Surg 2:249–254CrossRef
17.
Hawkins RJ, Switlyk P (1993) Acute prosthetic replacement for severe fractures of the proximal humerus. Clin Orthop Relat Res 289:156–160PubMed
18.
Zyto K, Kronberg M, Brostrom LA (1995) Shoulder function after displaced fractures of the proximal humerus. J Should Elb Surg 4:331–336CrossRef
19.
Compito CA, Self EB, Bigliani LU (1994) Arthroplasty and acute shoulder trauma. Reasons for success and failure. Clin Orthop Relat Res 307:27–36PubMed
20.
Demirhan M, Kilicoglu O, Altinel L, Eralp L, Akalin Y (2003) Prognostic factors in prosthetic replacement for acute proximal humerus fractures. J Orthop Trauma 17:181–189PubMedCrossRef
21.
Mighell MA, Kolm GP, Collinge CA, Frankle MA (2003) Outcomes of hemiarthroplasty for fractures of the proximal humerus. J Should Elb Surg 12:569–577CrossRef
22.
Robinson CM, Page RS, Hill RM, Sanders DL, Court-Brown CM, Wakefield AE (2003) Primary hemiarthroplasty for treatment of proximal humeral fractures. J Bone Joint Surg Am 85:1215–1223PubMedCrossRef
23.
Levy JC, Virani N, Pupello D, Frankle M (2007) Use of the reverse shoulder prosthesis for the treatment of failed hemiarthroplasty in patients with glenohumeral arthritis and rotator cuff deficiency. J Bone Joint Surg Br 89:189–195. doi:10.​1302/​0301-620X.​89B2.​18161 PubMedCrossRef
24.
Flury MP, Frey P, Goldhahn J, Schwyzer HK, Simmen BR (2011) Reverse shoulder arthroplasty as a salvage procedure for failed conventional shoulder replacement due to cuff failure-midterm results. Int Orthop 35(1):53–60. doi:10.​1007/​s00264-010-0990-z PubMedCrossRef
25.
Ortmaier R, Resch H, Matis N, Blocher M, Auffarth A, Mayer M, Hitzl W, Tauber M (2013) Reverse shoulder arthroplasty in revision of failed shoulder arthroplasty-outcome and follow-up. Int Orthop 37(1):67–75. doi:10.​1007/​s00264-012-1742-z PubMedCrossRef
26.
27.
28.
Carroll RM, Izquierdo R, Vazquez M, Blaine TA, Levine WN, Bigliani LU (2004) Conversion of painful hemiarthroplasty to total shoulder arthroplasty: long-term results. J Should Elb Surg 13:599–603. doi:10.​1016/​S105827460400133​8 CrossRef
29.
Gohlke F, Rolf O (2007) Revision of failed fracture hemiarthroplasties to reverse total shoulder prosthesis through the transhumeral approach: method incorporating a pectoralis-major-pedicled bone window. Oper Orthop Traumatol 19:185–208. doi:10.​1007/​s00064-007- 1202 PubMedCrossRef
30.
Petersen SA, Hawkins RJ (1998) Revision of failed total shoulder arthroplasty. Orthop Clin N Am 29:519–533CrossRef
31.
32.
Wirth MA, Tapscott RS, Southworth C, Rockwood CA Jr (2006) Treatment of glenohumeral arthritis with a hemiarthroplasty: a minimum five-year follow-up outcome study. J Bone Joint Surg Am 88:964–973PubMedCrossRef
33.
34.
Franta AK, Lenters TR, Mounce D et al (2007) The complex characteristics of 282 unsatisfactory shoulder arthroplasties. J Should Elb Surg 16:555–562CrossRef
35.
Wirth MA, Rockwood CA Jr. (1994) Complications of shoulder arthroplasty. Clin Orthop Relat Res 307:47–69PubMed
36.
Deutsch A, Abboud JA, Kelly J et al (2007) Clinical results of revision shoulder arthroplasty for glenoid component loosening. J Should Elb Surg 16:706–716CrossRef
37.
Hawkins RJ, Greis PE, Bonutti PM (1999) Treatment of symptomatic glenoid loosening following unconstrained shoulder arthroplasty. Orthopedics 22:229–234PubMed
38.
Postacchini R, Castagna A, Borroni M, Cinotti G, Postacchini F, Gumina S (2012) Total shoulder arthroplasty for the treatment of failed hemiarthroplasty in patients with fracture of the proximal humerus. J Should Elb Surg 21(11):1542–1549. doi:10.​1016/​j.​jse.​2011.​12.​007 CrossRef
39.
Dines JS, Fealy S, Strauss EJ et al (2006) Outcomes analysis of revision total shoulder replacement. J Bone Joint Surg Am 88:1494–1500PubMedCrossRef
40.
41.
42.
John M, Pap G, Angst F, Flury MP, Lieske S, Schwyzer HK, Simmen BR (2010) Short-term results after reversed shoulder arthroplasty (Delta III) in patients with rheumatoid arthritis and irreparable rotator cuff tear. Int Orthop 34(1):71–77. doi:10.​1007/​s00264-009-0733-1 PubMedCrossRef
43.
Metadata
Title
Conversion of shoulder arthroplasty to reverse implants: clinical and radiological results using a modular system
Authors
Alessandro Castagna
Marco Delcogliano
Francesca de Caro
Giovanni Ziveri
Mario Borroni
Stefano Gumina
Franco Postacchini
Carlo Felice De Biase
Publication date
01-07-2013
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 7/2013
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-013-1907-4

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