Clinical and radiological outcome following trauma-related reverse shoulder arthroplasty

• Published in: Archives of orthopaedic and trauma surgery 2024-07, Vol.144 (7), p.3103-3111
• Main Authors: Fischer, Cornelius Sebastian, Lohr, Christian, Ziegler, Patrick, Schüll, Daniel, Finger, Felix Christioph, Histing, Tina, Herbst, Moritz, Hemmann, Philipp
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Shoulder - methods; Female; Humans; Joint surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Orthopedics; Radiography; Range of motion; Range of Motion, Articular; Retrospective Studies; Shoulder; Shoulder Fractures - diagnostic imaging; Shoulder Fractures - surgery; Shoulder Joint - diagnostic imaging; Shoulder Joint - physiopathology; Shoulder Joint - surgery; Trauma Surgery; Treatment Outcome
• ISSN: 1434-3916; 0936-8051; 1434-3916
• DOI: 10.1007/s00402-024-05395-2

Background Reverse shoulder arthroplasty (RSA) is a frequently used therapy for complex proximal humeral fractures and posttraumatic disorders. The present study’s purpose was to assess the clinical and radiological outcome of primary and secondary RSA, and to analyze the impact of refixation of the greater tuberosity (GT). Patients and methods 28 patients with primary fracture RSA and 18 patients with RSA due to posttraumatic disorders were examined with a mean clinical follow-up of 2.5 ± 1.73 years. Operative details and radiographs were retrospectively reviewed. Additional analyses were performed for healed and non-healed GT in primary RSA. Results Patients with fracture RSA had higher Constant-Murley score (CMS) than secondary RSA without reaching significance ( p  = 0.104). No significant difference was present for the quality of life measured by the Short Form 36 (SF 36) and the range of motion. In primary RSA, 78.6% GT healed anatomically. Compared to non-healed GT, patients with healed GT had a significantly higher CMS ( p  = 0.011), external rotation ( p  = 0.026) and forward flexion ( p  = 0.083), whereas DASH score was lower without a significant difference ( p  = 0.268). SF 36 showed no significant difference. Patients with healed GT had a more neutral glenoid version ( p  = 0.009). Conclusion Superior range of motion and clinical outcome scores were present for anatomically healed GT. Therefore, refixation of the tuberosities is recommended. Secondary RSA can result in inferior results compared to primary RSA, so patients need to be adequately informed.