Impact of accumulating risk factors on the incidence of dislocation after primary reverse total shoulder arthroplasty using a medial glenoid-lateral humerus onlay prosthesis.
J Shoulder Elbow Surg
; 33(8): 1781-1788, 2024 Aug.
Article
en En
| MEDLINE
| ID: mdl-38316238
ABSTRACT
BACKGROUND:
The aim of this study was to facilitate preoperative identification of patients at risk for dislocation after reverse total shoulder arthroplasty (rTSA) using the Equinoxe rTSA prosthesis (medialized glenoid, lateralized onlay humerus with a 145° neck-shaft angle) and quantify the impact of accumulating risk factors on the occurrence of dislocation.METHODS:
We retrospectively analyzed 10,023 primary rTSA patients from an international multicenter database of a single platform shoulder prosthesis and quantified the dislocation rate associated with multiple combinations of previously identified risk factors. To adapt our statistical results for prospective identification of patients most at-risk for dislocation, we stratified our data set by multiple risk factor combinations and calculated the odds ratio for each cohort to quantify the impact of accumulating risk factors on dislocation.RESULTS:
Of the 10,023 primary rTSA patients, 136 (52 female, 83 male, 1 unknown) were reported to have a dislocation for a rate of 1.4%. Patients with zero risk factors were rare, where only 12.7% of patients (1268 of 10,023) had no risk factors, and only 0.5% of these (6 of 1268) had a report of dislocation. The dislocation rate increased in patient cohorts with an increasing number of risk factors. Specifically, the dislocation rate increased from 0.9% for a patient cohort with 1 risk factor to 1.0% for 2 risk factors, 1.6% for 3 risk factors, 2.7% for 4 risk factors, 5.3% for 5 risk factors, and 7.3% for 6 risk factors. Stratifying dislocation rate by multiple risk factor combinations identified numerous cohorts with either an elevated risk or a diminished risk for dislocation.DISCUSSION:
This multicenter study of 10,023 rTSA patients demonstrated that 1.4% of the patients experienced dislocation with one specific medialized glenoid-lateralized humerus onlay rTSA prosthesis. Stratifying patients by multiple combinations of risk factors demonstrated the impact of accumulating risk factors on the incidence of dislocation. rTSA patients with the greatest risk of dislocation were those of male sex, age ≤67 years at the time of surgery, patients with body mass index ≥31, patients who received cemented humeral stems, patients who received glenospheres having a diameter >40 mm, and/or patients who received expanded or laterally offset glenospheres. Patients with these risk factors who are considering rTSA using a medial glenoid-lateral humerus should be made aware of their elevated dislocation risk profile.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Diseño de Prótesis
/
Luxación del Hombro
/
Artroplastía de Reemplazo de Hombro
/
Prótesis de Hombro
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Shoulder Elbow Surg
Asunto de la revista:
ORTOPEDIA
Año:
2024
Tipo del documento:
Article
Pais de publicación:
Estados Unidos