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. 2021 Jul 8;22(1):27.
doi: 10.1186/s10195-021-00592-w.

Problems, complications, and reinterventions in 4893 onlay humeral lateralized reverse shoulder arthroplasties: a systematic review (part I-complications)

Francesco Ascione  1   2 , Alfredo Schiavone Panni  3 , Adriano Braile  3 , Katia Corona  4 , Giuseppe Toro  3 , Nicola Capuano  5 , Alfonso M Romano  5   6
Affiliations

Problems, complications, and reinterventions in 4893 onlay humeral lateralized reverse shoulder arthroplasties: a systematic review (part I-complications)

Francesco Ascione et al. J Orthop Traumatol. .

Abstract

Background: Several modifications to the original Grammont reverse shoulder arthroplasty (RSA) design have been proposed to prevent distinctive issues, such as both glenoid and humeral lateralization. The aim of this systematic review was to determine rates of problems, complications, reoperations, and revisions after onlay lateralized humeral stem RSA, hypothesizing that these are design related.

Methods: This systematic review was performed in accordance with the PRISMA statement guidelines. A literature search was conducted (01.01.2000-14.04.2020) using PubMed, Cochrane Reviews, Scopus, and Google Scholar employing several combinations of keywords: "reverse shoulder arthroplasty," "reverse shoulder prosthesis," "inverse shoulder arthroplasty," "inverse shoulder prosthesis," "problems," "complications," "results," "outcomes," "reoperation," "revision."

Results: Thirty-one studies with 4893 RSA met inclusion criteria. The 892 postoperative problems and 296 postoperative complications represented overall problem and complication rates of 22.7% and 7.5%, respectively. Forty-one reoperations and 63 revisions resulted, with an overall reoperation rate of 1.7% and overall revision rate of 2.6%.

Conclusions: Problem, complication, and reintervention rates proved acceptable when implanting a high humeral lateralization stem in RSA. The most frequent problem was scapular notching (12.6%), and the most common postoperative complication was scapular stress fracture (1.8%). An overall humeral complication rate of 1.9% was identified, whereas short stems reported no humeral fractures or stem loosening. Infections (1.3%) proved to be the most common reason for component revision, and instability had a complication rate of 0.8%.

Level of evidence: Systematic review IV.

Keywords: Dislocation; Grammont; Humeral offset; Infection; Radiographic findings; Results; Revision.

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Conflict of interest statement

Francesco Ascione and Alfonso M. Romano receive fees for consulting from Exactech Inc. The other authors, their immediate family, and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.

Figures

Fig. 1
Fig. 1
Studies collection and inclusion process
See this image and copyright information in PMC

References

    1. Boileau P, Watkinson DJ, Hatzidakis AM, Balg F. Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elbow Surg. 2005;14:S147–S161. doi: 10.1016/j.jse.2004.10.006. - DOI - PubMed
    1. Sirveaux F, Favard L, Oudet D, et al. Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Joint Surg Br. 2004;86:388–395. doi: 10.1302/0301-620x.86b3.14024. - DOI - PubMed
    1. Wall B, Nové-Josserand L, OʼConnor DP, , et al. Reverse total shoulder arthroplasty: a review of results according to etiology. J Bone Jt Surg. 2007;89:1476–1485. doi: 10.2106/JBJS.F.00666. - DOI - PubMed
    1. Werner CML. Treatment of painful pseudoparesis due to irreparable rotator cuff dysfunction with the delta III reverse-ball-and-socket total shoulder prosthesis. J Bone Jt Surg Am. 2005;87:1476. doi: 10.2106/JBJS.D.02342. - DOI - PubMed
    1. Rojas J, Joseph J, Liu B, et al. Can patients manage toileting after reverse total shoulder arthroplasty? A systematic review. Int Orthop. 2018;42:2423–2428. doi: 10.1007/s00264-018-3900-4. - DOI - PubMed

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