RESUMEN
AIMS: Heterotopic ossification (HO) occurs after arthroplasty, especially total hip arthroplasty. In this study we describe the incidence, evolution, morphology and clinical consequences of HO following reverse shoulder arthroplasty. PATIENTS AND METHODS: This is a single-centre retrospective study of 132 consecutive patients who received a Delta III or Delta Xtend reverse total shoulder arthroplasty between 2006 and 2013 for the treatment of cuff tear arthropathy. There were 96 women and 36 men. Their mean age at the time of surgery was 69 years (49 to 89) and the mean follow-up was 36 months (12 to 84). The incidence, evolution, morphology and clinical consequences of HO using the Constant-Murley score (CS) were analysed. A modified Brooker classification of HO of the hip was used. RESULTS: HO was seen in 39 patients (29.5%). A total of 31 of these patients (81.6%) began to develop HO by three months post-operatively. According to the Hamada classification, 11 patients had grade 1a, eight had grade 1b, six had grade 1c and 14 had grade 2 HO. The HO evolved over a mean of 8.3 months (3 to 21). Patients with HO had a lower mean CS at three (p = 0.017), six (p < 0.001) and 12 months (p < 0.001) post-operatively. HO was not associated with notching (p = 0.675). CONCLUSION: HO after reverse shoulder arthroplasty is a non-progressive condition without long-term clinical consequences. Only grade 2 HO is clinically relevant with a negative effect on the function of the shoulder during its development. Cite this article: Bone Joint J 2016;98-B:1215-21.
Asunto(s)
Artroplastía de Reemplazo de Hombro/efectos adversos , Artroplastía de Reemplazo de Hombro/métodos , Osificación Heterotópica/etiología , Distribución por Edad , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Osificación Heterotópica/epidemiología , Osificación Heterotópica/fisiopatología , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Distribución por SexoRESUMEN
Chronic glenohumeral dislocation is a rare entity and several treatment options have been proposed. The aim of this study is to report the long-term follow-up of the reversed shoulder arthroplasty in patients with chronic glenohumeral dislocation. A retrospective analysis of all patients between January 2002 and December 2012 that were treated with a reversed shoulder arthroplasty for chronic anterior glenohumeral dislocations was performed. Pre-operative CT evaluation of the bone loss and fatty degeneration of the rotator cuff muscles was performed. Pre- and postoperative Constant-Murley score was evaluated. 6 patients (4 males and 2 females) with anterior glenohumeral dislocations were evaluated. Average age was 73 years (between 65-86 years). The average time of dislocation was 18 weeks (between 4 and 52 weeks). Average time of follow-up was 39 months (between 12 and 90 months). The CM improved from 33 (between 17 and 45) pre-op to 76 postop (between 55 and 89). No postoperative complications were observed. Reversed shoulder arthroplasty gives good results in case of chronic glenohumeral dislocation.