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[Shoulder joint instability after primary arthroplasty]

J F Löhr1, M Flören, H K Schwyzer

  • 1Klinik Wilhelm Schulthess Zürich.

Der Orthopade
|October 21, 1998
PubMed
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Shoulder arthroplasty can lead to instability, including subluxation and dislocation. Revision surgeries for shoulder instability reveal it as a common complication, with results often inferior to primary procedures.

Area of Science:

  • Orthopedic Surgery
  • Biomechanical Engineering

Background:

  • Shoulder instability, encompassing subluxation and dislocation, is a frequent complication following shoulder arthroplasty.
  • Instability can manifest in various directions (anterior, posterior, inferior, cranial) due to imbalances in muscular forces, capsular stabilizers, and bony anatomy.
  • Pre-existing conditions like posterior glenoid wear in osteoarthritis can predispose to early subluxation.

Purpose of the Study:

  • To investigate the incidence and characteristics of instability as a complication in shoulder revision surgeries.
  • To evaluate the outcomes of revision shoulder arthroplasty compared to primary procedures, specifically concerning instability.

Main Methods:

  • Analysis of 44 shoulder revision surgeries to identify the most common complications.

Related Experiment Videos

  • Assessment of patient outcomes using the Constant Score (average 41.9).

    • Main Results:

    • Instability was identified as the most frequent complication in the studied cohort of shoulder revision surgeries.
    • Revision surgery outcomes, as indicated by the Constant Score, suggest that excellent results seen in primary arthroplasties are not typically achieved.
    • Both anterior and posterior instability were observed, in addition to late cranialization of the rotator cuff-deficient shoulder.

    Conclusions:

    • Instability is a significant complication in shoulder revision surgery.
    • Revision shoulder arthroplasty yields lower functional outcomes compared to primary procedures.
    • Comprehensive assessment and management of various instability types are crucial in revision shoulder arthroplasty.