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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
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Reverse Shoulder Arthroplasty for Failed Operative Treatment of Proximal Humeral Fractures
Zinon T Kokkalis1, Aikaterini Bavelou1, Efstratios Papanikos1
1Department of Orthopaedics, University of Patras, School of Medicine, University Hospital of Patras, Patras, Greece.
Journal of Shoulder and Elbow Arthroplasty
|June 7, 2022
Summary
Revision surgery using reverse shoulder arthroplasty (RSA) effectively treats complex proximal humeral fractures (PHF) that failed primary surgery. This approach offers good clinical outcomes and pain relief for patients.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Arthroplasty
Background:
- Complex proximal humeral fractures (PHF) pose challenges in operative treatment, with failures necessitating revision strategies.
- Reverse shoulder arthroplasty (RSA) is increasingly considered for complex shoulder reconstructions.
Purpose of the Study:
- To evaluate the clinical outcomes and complications of revision surgery with RSA for failed primary treatment of PHF.
- To assess the efficacy of RSA as a salvage procedure for complex proximal humeral fractures.
Main Methods:
- A case series of 14 patients undergoing revision surgery with RSA for failed PHF treatment was analyzed.
- Patients were evaluated for Constant Score (CS), Visual Analogue Scale (VAS), Range of Motion, and radiological assessment.
- Primary treatments included ORIF, hemiarthroplasty, closed reduction, and transosseous suture fixation.
Main Results:
- Significant improvements were observed in mean absolute CS, VAS score, active anterior elevation, and active abduction post-RSA.
- External rotation showed a less significant improvement (P=.0304).
- No significant differences in outcomes were noted between different primary failed techniques; no postoperative complications occurred.
Conclusions:
- Reverse shoulder arthroplasty (RSA) is a suitable revision technique for failed primary surgical treatment of complex proximal humeral fractures (PHF).
- Despite surgical challenges, RSA provides good clinical results and effective pain relief in revision settings.
