Medium- to long-term outcomes after reverse total shoulder arthroplasty with a standard long stem

Background: Long-term clinical and radiographic outcome data after standard cemented long-stem reverse shoulder arthroplasty (RSA) remain underreported. The aim of this study is to report on medium- to long-term data of patients over 60 years of age. Methods: The same type of RSA (Aequalis Reverse I...

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Hauptverfasser: Bülhoff, Matthias (VerfasserIn) , Zeifang, Felix (VerfasserIn) , Welters, Caroline Charlotte (VerfasserIn) , Renkawitz, Tobias (VerfasserIn) , Schiltenwolf, Marcus (VerfasserIn) , Nolte, Anna-Katharina (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 19 April 2022
In: Journal of Clinical Medicine
Year: 2022, Jahrgang: 11, Heft: 9, Pages: 1-11
ISSN:2077-0383
DOI:10.3390/jcm11092274
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/jcm11092274
Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2077-0383/11/9/2274
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Verfasserangaben:Matthias Bülhoff, Felix Zeifang, Caroline Welters, Tobias Renkawitz, Marcus Schiltenwolf and Anna-K. Tross

MARC

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520 |a Background: Long-term clinical and radiographic outcome data after standard cemented long-stem reverse shoulder arthroplasty (RSA) remain underreported. The aim of this study is to report on medium- to long-term data of patients over 60 years of age. Methods: The same type of RSA (Aequalis Reverse II, Memphis, TN, USA) was implanted in 27 patients with a mean age of 73 years (range 61-84). Indications for RSA were cuff tear arthropathy (CTA) in 25 cases and osteoarthritis (OA) in two cases. Pre- and postoperative Constant Score was assessed and component loosening, polyethylene wear, scapular notching and revision rates were recorded at a mean clinical follow-up (FU) of 127.6 months (SD ± 33.7; range 83-185). Results: The mean-adjusted CS (aCS) improved from 30.0 (range 10-59) to 95.0 (range 33-141) points (p < 0.001). Glenoid loosening was found in two (9.1%) and stem loosening was found in three (13.6%) cases. Polyethylene wear was observed in four (18.2%) cases. Scapular notching appeared in 15 (68.2%) cases but was not associated with poor aCS (p = 0.423), high levels of pain (p = 0.798) or external rotation (p = 0.229). Revision surgery was necessary in three (11.1%) cases. Conclusions: RSA with a cemented standard long stem leads to improvement in forward elevation, abduction and pain after a mean FU of 10 years. However, external rotation does not improve with this prosthetic design. Moreover, scapular notching is observed in the majority of cases, and revision rates (11.1%) as well as humeral loosening rates (13.6%) remain a concern. Level of evidence: Level 4, retrospective cohort study. 
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