Purpose: The aim of this study is to retrospectively compare clinical and radiographic outcomes of patients treated with non-lateralizing reverse shoulder arthroplasty (RSA) and with humeral lateralizing RSA after proximal humerus fracture (PHF). Methods: In total, 32 patients (8 men and 24 women), with a mean age of 77.4 (67–92), have been reevaluated (follow-up of 14.3 months) and divided into Grammont group (G-group—16 patients, 2 men and 14 women, mean age 82.3) and lateralizing group (L-group—16 patients, 4 men and 12 women, mean age 72.5). The dominant side was affected in 21 patients. Pain, Constant–Murley score (CMS), range of motion accurately measured with inertial sensors (SHoWlder, NCSLab®) and complications. Anatomic tuberosity healing, signs of loosening or mobilization of the implants and scapular notching (according to Sirveaux classification) have been measured on standard X-ray series (antero-posterior view in neutral, external and internal rotation; axillary view; outlet view). Results: Similar CMS was recorded between the two groups (G-group: 61/100; L-group: 64/100). G-group had higher forward flexion (128° vs. 112°) and abduction (126° vs. 114°), L-group had higher external rotation in abduction (35° vs. 41°); similar internal rotation (sacrum) and rotation with elbow in adduction were measured (12° vs. 19°). No statistically significant differences emerged. Anatomic healing of the tuberosity was higher in G-group (87.5% vs. 50%); low-grade scapular notching was higher in L-group (18.25% grade 1–2 vs. 0). Anatomic healed tuberosity guaranteed highly statistically significant improved functional outcomes. No revisions of the implant were performed. Conclusions: RSA can be considered a valid solution for the treatment of PHF in elderly low-demanding population. Cuff conditions should be investigated before surgery for the indication of the adequate model.

Grammont versus lateralizing reverse shoulder arthroplasty for proximal humerus fracture: functional and radiographic outcomes / Verdano, M. A.; Aliani, D.; Galavotti, C.; Maroun, C.; Vaienti, E.; Ceccarelli, F.. - In: MUSCULOSKELETAL SURGERY. - ISSN 2035-5106. - 102:Suppl 1(2018), pp. 57-65. [10.1007/s12306-018-0565-5]

Grammont versus lateralizing reverse shoulder arthroplasty for proximal humerus fracture: functional and radiographic outcomes

Verdano, M. A.;Aliani, D.;Galavotti, C.;Vaienti, E.;Ceccarelli, F.
2018

Abstract

Purpose: The aim of this study is to retrospectively compare clinical and radiographic outcomes of patients treated with non-lateralizing reverse shoulder arthroplasty (RSA) and with humeral lateralizing RSA after proximal humerus fracture (PHF). Methods: In total, 32 patients (8 men and 24 women), with a mean age of 77.4 (67–92), have been reevaluated (follow-up of 14.3 months) and divided into Grammont group (G-group—16 patients, 2 men and 14 women, mean age 82.3) and lateralizing group (L-group—16 patients, 4 men and 12 women, mean age 72.5). The dominant side was affected in 21 patients. Pain, Constant–Murley score (CMS), range of motion accurately measured with inertial sensors (SHoWlder, NCSLab®) and complications. Anatomic tuberosity healing, signs of loosening or mobilization of the implants and scapular notching (according to Sirveaux classification) have been measured on standard X-ray series (antero-posterior view in neutral, external and internal rotation; axillary view; outlet view). Results: Similar CMS was recorded between the two groups (G-group: 61/100; L-group: 64/100). G-group had higher forward flexion (128° vs. 112°) and abduction (126° vs. 114°), L-group had higher external rotation in abduction (35° vs. 41°); similar internal rotation (sacrum) and rotation with elbow in adduction were measured (12° vs. 19°). No statistically significant differences emerged. Anatomic healing of the tuberosity was higher in G-group (87.5% vs. 50%); low-grade scapular notching was higher in L-group (18.25% grade 1–2 vs. 0). Anatomic healed tuberosity guaranteed highly statistically significant improved functional outcomes. No revisions of the implant were performed. Conclusions: RSA can be considered a valid solution for the treatment of PHF in elderly low-demanding population. Cuff conditions should be investigated before surgery for the indication of the adequate model.
Grammont versus lateralizing reverse shoulder arthroplasty for proximal humerus fracture: functional and radiographic outcomes / Verdano, M. A.; Aliani, D.; Galavotti, C.; Maroun, C.; Vaienti, E.; Ceccarelli, F.. - In: MUSCULOSKELETAL SURGERY. - ISSN 2035-5106. - 102:Suppl 1(2018), pp. 57-65. [10.1007/s12306-018-0565-5]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11381/2855521
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