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Jennewine BR, James NF, Polio WP, Naser AM, Nieboer MJ, Schoch BS, Throckmorton TW, Bernholt DL, Azar FM, Brolin TJ. Superior humeral head osteophytes are associated with rotator cuff insufficiency in glenohumeral osteoarthritis: a retrospective analysis. Eur J Orthop Surg Traumatol 2024; 34:893-900. [PMID: 37770594 DOI: 10.1007/s00590-023-03727-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/04/2023] [Indexed: 09/30/2023]
Abstract
PURPOSE The primary goal of this study was to investigate whether superior humeral head osteophyte (SHO) size is associated with rotator cuff insufficiency, including rotator cuff tear (RCT), supraspinatus tendon thickness, and fatty infiltration of the rotator cuff muscles. METHODS Patients ≥ 18 years who were diagnosed with glenohumeral osteoarthritis were retrospectively reviewed. SHO size was determined by radiograph. MRI measured SHO and RCT presence, type, and size; supraspinatus tendon thickness; and fatty infiltration of rotator cuff musculature. RESULTS A total of 461 patients were included. Mean SHO size was 1.93 mm on radiographs and 2.13 mm on MRI. Risk ratio for a RCT was 1.14. For each 1-mm increase in SHO size on radiograph, supraspinatus tendon thickness decreased by 0.20 mm. SHO presence was associated with moderate-to-severe fatty infiltration of the supraspinatus with a risk ratio of 3.16. CONCLUSION SHOs were not associated with RCT but were associated with higher risk of supraspinatus FI and decreased tendon thickness, which could indicate rotator cuff insufficiency. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Brenton R Jennewine
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN, 38104, USA
| | - Nicholas F James
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN, 38104, USA
| | - William P Polio
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN, 38104, USA
| | - Abu Mohd Naser
- Division of Epidemiology, Biostatistics, and Environmental Health, University of Memphis, Memphis, TN, USA
| | - Micah J Nieboer
- Department of Orthopaedic Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Bradley S Schoch
- Department of Orthopaedic Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Thomas W Throckmorton
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN, 38104, USA
| | - David L Bernholt
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN, 38104, USA
| | - Frederick M Azar
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN, 38104, USA
| | - Tyler J Brolin
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN, 38104, USA.
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Wolf M, Bülhoff M, Raiss P, Zeifang F, Maier MW. Effect of the critical shoulder angle on severe cranialization following total shoulder arthroplasty. J Orthop 2020; 21:240-4. [PMID: 32280160 DOI: 10.1016/j.jor.2020.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 03/22/2020] [Indexed: 11/22/2022] Open
Abstract
PURPOSE This study assesses the relationship of CSA, cranialization and radiographic glenoid loosening following TSA in the long-term follow-up. METHODS 26 shoulders with TSA were examined radiographically postoperatively and after a mean 12.6 years. Severe cranialization was defined as direct humeral contact with the acromion and/or acetabularization of the acromion. RESULTS A CSA ≥35° was associated with severe cranialization. Glenoid loosening was present in 6/24 shoulders (25%). Severe cranialization was associated with glenoid loosening (p = 0.003). CONCLUSION A postoperative CSA ≥ 35° was associated with severe humeral cranialization after TSA in the long-term follow-up. Severe cranialization correlated with glenoid loosening.Level of evidence IV - retrospective cohort study.
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Holschen M, Franetzki B, Witt KA, Liem D, Steinbeck J. Is reverse total shoulder arthroplasty a feasible treatment option for failed shoulder arthroplasty? A retrospective study of 44 cases with special regards to stemless and stemmed primary implants. Musculoskelet Surg 2017; 101:173-180. [PMID: 28205145 DOI: 10.1007/s12306-017-0467-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 02/07/2017] [Indexed: 12/31/2022]
Abstract
Is reverse total shoulder arthroplasty a feasible treatment option for failed shoulder arthroplasty? A retrospective study of 44 cases with special regards to stemless and stemmed primary implants. BACKGROUND Due to humeral or glenoid bone-loss and rotator cuff insufficiency reverse total shoulder arthroplasty often means the only remaining treatment option in revision shoulder arthroplasty. This study investigates the clinical outcome of patients treated with a reverse total shoulder in revision cases with special regard to stemless and stemmed primary implants. MATERIALS AND METHODS From 2010 to 2012 60 failed shoulder arthroplasties were converted to reverse total shoulder arthroplasty. Forty-four patients were available for follow-up after a mean of 24 months. Patients were assessed with X-rays, Constant- and ASES Score and a questionnaire about their subjective satisfaction. RESULTS The total number of observed complications was seven (16%). Ninety-eight percent of the patients were satisfied with their clinical result. Patients achieved a mean normalized constant score of 70.2% and a mean ASES Score of 65.3. Patients with stemless primary implants achieved a higher normalized constant score than patients with stemmed primary implants (82 vs. 61.8%; p = 0009). CONCLUSION Reverse total shoulder arthroplasty provides satisfactory clinical results and a high patient satisfaction in revision shoulder arthroplasty. The complication rate needs to be considered and discussed with the patient prior to surgery. Presence or absence of a stem of revised shoulder arthroplasties interferes with the outcome. LEVEL OF EVIDENCE IV: (Retrospective study).
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Affiliation(s)
- M Holschen
- Orthopedic Practice Clinic (OPPK), Von-Vincke-Str. 14, 48143, Münster, Germany.
| | - B Franetzki
- Orthopedic Practice Clinic (OPPK), Von-Vincke-Str. 14, 48143, Münster, Germany
| | - K-A Witt
- Orthopedic Practice Clinic (OPPK), Von-Vincke-Str. 14, 48143, Münster, Germany
| | - D Liem
- Orthopedic Department of the University of Münster, Münster, Germany
| | - J Steinbeck
- Orthopedic Practice Clinic (OPPK), Von-Vincke-Str. 14, 48143, Münster, Germany
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Holschen M, Franetzki B, Witt KA, Liem D, Steinbeck J. Conversions from anatomic shoulder replacements to reverse total shoulder arthroplasty: do the indications for initial surgery influence the clinical outcome after revision surgery? Arch Orthop Trauma Surg 2017; 137:167-172. [PMID: 27858226 DOI: 10.1007/s00402-016-2595-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The most frequent indications for anatomic shoulder replacement are glenohumeral osteoarthritis and fractures of the humeral head. If anatomic shoulder prostheses fail, reverse total shoulder arthroplasty is often the only remaining treatment option. This study evaluates the influence of indications for primary shoulder arthroplasty on the clinical outcome after conversion to reverse total shoulder arthroplasty. MATERIALS AND METHODS From 2010 to 2012, 44 failed shoulder arthroplasties were converted to reverse total shoulder arthroplasty. Forty-four patients were available for follow-up after a mean of 24 months (14-36 months). Twenty-three of them had received an initial shoulder replacement because of osteoarthritis, while the remaining 21 patients had been treated for a fracture of the humeral head. At follow-up, patients were assessed with X-rays, constant-, and ASES scores. RESULTS The total number of observed complications was higher in patients revised because of failed fracture arthroplasty (24 vs. 9%). Patients initially treated for osteoarthritis achieved a higher ASES score (71 vs. 59 points; p = 0.048). The normalized constant score was not different between the two observed groups (osteoarthritis 73% vs. fracture 67%: p = 0.45). Complications occurred more often in patients who had initially suffered from a fracture of the humeral head (fracture 23.8% vs. osteoarthritis 8.7%). Scapular notching was more frequent after initial fracture arthroplasty (33 vs. 14%). CONCLUSION Indications for initial shoulder replacement have an influence on the clinical outcome after conversion to reverse total shoulder arthroplasty. Patients initially treated for a fracture of the humeral head have a lower subjective outcome and a higher complication rate in comparison with patients initially treated for osteoarthritis. LEVEL OF EVIDENCE IV (Retrospective study).
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Affiliation(s)
- Malte Holschen
- Orthopedic Practice Clinic (OPPK), Schürbusch 55, 48143, Münster, Germany.
| | - Bastian Franetzki
- Orthopedic Practice Clinic (OPPK), Schürbusch 55, 48143, Münster, Germany
| | - Kai-Axel Witt
- Orthopedic Practice Clinic (OPPK), Schürbusch 55, 48143, Münster, Germany
| | - Dennis Liem
- Orthopedic Department of the University of Münster, Münster, Germany
| | - Jörn Steinbeck
- Orthopedic Practice Clinic (OPPK), Schürbusch 55, 48143, Münster, Germany
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