Reverse shoulder arthroplasty in patients with os acromiale

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Radiology

Background:

• Os acromiale affects up to 15% of the population.
• Reverse total shoulder arthroplasty (RTSA) may increase stress on os acromiale.
• This study investigates RTSA outcomes in patients with os acromiale.

Purpose of the Study:

• To evaluate the outcomes and complications of primary RTSA in patients with radiographic evidence of os acromiale.
• To assess the impact of os acromiale on RTSA results.
• To identify potential risks associated with RTSA in the presence of os acromiale.

Main Methods:

• Retrospective review of 25 shoulders undergoing primary RTSA with os acromiale (2005-2013).
• Minimum 2-year follow-up or until reoperation.
• Outcomes measured: pain, range of motion, patient satisfaction, American Shoulder and Elbow Surgeons scores, and radiographic findings.

Main Results:

• Significant improvement in pain scores for 24 of 25 patients.
• Enhanced mean elevation (124°), external rotation (46°), and internal rotation (L4).
• 3 patients required reoperation (2 for dislocation, 1 for os acromiale excision); 28% showed postoperative os acromiale tilting without affecting outcomes.

Conclusions:

• Os acromiale does not appear to negatively affect RTSA outcomes.
• Pain related to os acromiale after RTSA is infrequent.
• Postoperative inferior tilting of os acromiale occurs in about one-third of cases but does not alter overall results.