Conversion to hemi-shoulder arthroplasty or reverse total shoulder arthroplasty after failed plate osteosynthesis of proximal humerus fractures: a retrospective study

Objective To assess the clinical outcomes of hemi-shoulder arthroplasty (HSA) versus reverse total shoulder arthroplasty (RTSA) following failed plate osteosynthesis of proximal humerus fractures in elderly patients. Methods This retrospective study identified all patients that had a documented fail...

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Bibliographic Details
Published in:Journal of international medical research 2020-08, Vol.48 (8), p.300060520931241-300060520931241
Main Authors: Han, Xiulan, Zhuang, Jintao, Yu, Weiguang, Gao, Yixin, Zhao, Mingdong, Ye, Junxing, Han, Guowei, Zeng, Xianshang
Format: Article
Language:English
Subjects:
Aged
Arthroplasty, Replacement, Shoulder
Humans
Humerus
Joint replacement surgery
Joint surgery
Range of Motion, Articular
Reoperation
Retrospective Clinical Research Report
Retrospective Studies
Shoulder
Shoulder Fractures - diagnostic imaging
Shoulder Fractures - surgery
Shoulder Joint - surgery
Treatment Outcome
United States
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Summary:Objective To assess the clinical outcomes of hemi-shoulder arthroplasty (HSA) versus reverse total shoulder arthroplasty (RTSA) following failed plate osteosynthesis of proximal humerus fractures in elderly patients. Methods This retrospective study identified all patients that had a documented failed plate osteosynthesis of proximal humeral fractures treated with revision HSA or RTSA. Follow-up occurred at 1, 3, 6 and 12 months after surgery and every year thereafter. The primary outcomes were the American Shoulder and Elbow Surgeons (ASES) scores, Simple Shoulder Test (SST) scores, visual analogue scale (VAS) pain scores and the University of California, Los Angeles Shoulder Rating Scale (UCLA SRS) scores. The secondary outcome was the rate of major complications. Results A total of 126 patients (126 shoulders) were enrolled in the study. At the final follow-up, the RTSA group had significantly greater improvements in ASES, SST and UCLA SRS scores than the HSA group. The RTSA group had significantly larger decreases in the VAS pain score compared with the HSA group. The rate of major complications was significantly higher in the HSA group than in the RTSA group (44.4% versus 27.5%, respectively). Conclusion RTSA provided superior functional outcomes compared with HSA, with a lower rate of major complications after a follow-up period of at least 5 years.
ISSN:0300-0605
1473-2300
DOI:10.1177/0300060520931241