Reverse total shoulder replacement for patients with "weight-bearing" shoulders

Journal article

Levy, Ofer, Arealis, Georgios, Tsvieli, Oren, Consigliere, Paolo and Lubovsky, Omri 2024. Reverse total shoulder replacement for patients with "weight-bearing" shoulders. Clinics in Shoulder and Elbow. https://doi.org/cise.2023.00535
AuthorsLevy, Ofer, Arealis, Georgios, Tsvieli, Oren, Consigliere, Paolo and Lubovsky, Omri
AbstractReverse total shoulder arthroplasty (rTSA) has gained popularity in recent years and is indicated for a wide variety of shoulder pathologies. However, use of rTSA in patients with "weight-bearing" shoulders that support wheelchair use or crutches has higher risk. The aim of this study was to assess the results of rTSA in such patients. Between 2005 and 2014, 24 patients (30 shoulders) with weight-bearing shoulders were treated with rTSA at our unit. Patients had cuff arthropathy (n=21), rheumatoid arthritis (n=3), osteoarthritis (n=1), acute fracture (n=3), or fracture sequela (n=2). Postoperatively, patients were advised not to push themselves up and out of their wheelchair for 6 weeks. The study surgeries were performed in 2016, and 21 patients (27 shoulders) who were available for a mean follow-up of 5.6 years (range, 2-10 years). The mean age on surgery day was 78 years (range, 54-90 years). Constant-Murley score improved from 9.4 (range, 2-26) preoperatively to 59.8 (range, 29-80) at the final follow-up (P=0.001). Pain improved from 2/15 (range, 0-8) to 13.8/15 (range, 9-15) (P=0.001). Patient satisfaction (Subjective Shoulder Value) improved from 0.6/10 to 8.7/10 (P=0.001) at final follow-up. Significant improvement in mean range of motion from 46° to 130° of elevation, 13° to 35° of external rotation, and 29° to 78° internal rotation was recorded (P=0.001). Final mean Activities of Daily Living External and Internal Rotation was 32.4/36 (range, 16-36). There were three patients with Sirveaux-Nerot grade-1 (10%) glenoid notching and three with grade 2 (10%). rTSA can be used for treatment of patients with weight-bearing shoulders. Such patients reported pain free movement, resumed daily activities, and high satisfaction rates.
KeywordsWheelchair; Crutches; Weight bearing shoulders; Reverse total shoulder arthroplasty; Arthritis
Year2024
JournalClinics in Shoulder and Elbow
ISSN2288-8721
Digital Object Identifier (DOI)https://doi.org/cise.2023.00535
Official URLhttps://www.cisejournal.org/journal/view.php?number=968
Related URLhttps://pubmed.ncbi.nlm.nih.gov/38556915/
Publication dates
Online13 Mar 2024
Publication process dates
Accepted23 Nov 2023
Deposited15 Apr 2024
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File Access Level
Open
Output statusPublished
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https://repository.canterbury.ac.uk/item/979v7/reverse-total-shoulder-replacement-for-patients-with-weight-bearing-shoulders

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