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Primary and revision reverse total shoulder arthroplasty using a patient-matched glenoid implant for severe glenoid bone deficiency.
Michelin, Richard M; Manuputy, Isaac; Rangarajan, Rajesh; Lee, Brian K; Schultzel, Mark; Itamura, John M.
Afiliación
  • Michelin RM; Cedars Sinai-Kerlan Jobe Institute, Los Angeles, CA, USA; White Memorial Medical Center, Los Angeles, CA, USA; Crovetti Orthopaedics and Sports Medicine, Las Vegas, NV, USA. Electronic address: michelinortho@gmail.com.
  • Manuputy I; Cedars Sinai-Kerlan Jobe Institute, Los Angeles, CA, USA; White Memorial Medical Center, Los Angeles, CA, USA.
  • Rangarajan R; Cedars Sinai-Kerlan Jobe Institute, Los Angeles, CA, USA; White Memorial Medical Center, Los Angeles, CA, USA.
  • Lee BK; Cedars Sinai-Kerlan Jobe Institute, Los Angeles, CA, USA; White Memorial Medical Center, Los Angeles, CA, USA.
  • Schultzel M; United Medical Doctors, San Diego, CA, USA.
  • Itamura JM; Cedars Sinai-Kerlan Jobe Institute, Los Angeles, CA, USA; White Memorial Medical Center, Los Angeles, CA, USA.
J Shoulder Elbow Surg ; 33(6S): S93-S103, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38492629
ABSTRACT

BACKGROUND:

Severe glenoid bone loss in the setting of both primary and revision reverse total shoulder arthroplasty (rTSA) continues to remain a significant challenge. The purpose of this study was to report on radiographic and clinical outcomes of primary and revision rTSA using a patient-matched, 3-dimensionally printed metal glenoid implant to address severe glenoid bone deficiency. This is a follow-up study to previously reported preliminary results.

METHODS:

A retrospective review was performed on 62 patients with severe glenoid bone deficiency who underwent either primary or revision rTSA using the Comprehensive Vault Reconstruction System (VRS) (Zimmer Biomet) at a single institution. Preoperative and postoperative values for the Disabilities of the Arm, Shoulder and Hand (DASH), Constant, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), Simple Shoulder Test (SST), Single Assessment Numeric Evaluation (SANE), and visual analog scale (VAS) pain scores as well as active range of motion (ROM) were collected and compared using the Wilcoxon signed rank test with the level of statistical significance set at P < .05. The percentage of patients achieving minimal clinically important difference (MCID) and substantial clinical benefit (SCB) was also calculated.

RESULTS:

Fifty-five of 62 shoulders (88.7%) were able to be contacted at a minimum of 2 years postoperatively, with 47 of 62 (75.8%) having complete clinical and radiographic follow-up with a mean age of 67.5 years (range, 48-85 years) and follow-up of 39.2 months (range, 25-56 months). There were 19 primary and 28 revision rTSAs. Significant improvements were seen in mean active forward flexion (63.1° ± 30.3° to 116.8° ± 35°), abduction (48.1° ± 16.1 to 76.2° ± 13.4°) (P < .001), external rotation (16° ± 23.7° to 32.1° ± 24.5°) (P < .005), DASH (59.9 ± 17.7 to 35.7 ± 24.3), Constant (23.4 ± 13.1 to 53.1 ± 17.4), ASES (27.8 ± 16.2 to 69.1 ± 25.2), SST (3.3 ± 2.5 to 7.6 ± 3.5), SANE (28.9 ± 18.3 to 66.7 ± 21.2), and VAS pain (7.1 ± 2.4 to 1.8 ± 2.6) scores (P < .001). MCID and SCB was achieved in a majority of patients postoperatively. The overall complication rate was 29.1%, with only 1 baseplate failure.

CONCLUSION:

This study demonstrates promising evidence that the VRS implant can be used as a viable option to achieve clinically important improvement in a majority of patients treated for severe glenoid bone deficiency with rTSA in both the primary and revision setting.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diseño de Prótesis / Reoperación / Articulación del Hombro / Rango del Movimiento Articular / Artroplastía de Reemplazo de Hombro / Prótesis de Hombro 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
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diseño de Prótesis / Reoperación / Articulación del Hombro / Rango del Movimiento Articular / Artroplastía de Reemplazo de Hombro / Prótesis de Hombro 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