Skip to main content
SpringerLink
Log in

Does the reverse shoulder arthroplasty durably restore function in trauma?

  • Original Article
  • Published:
European Orthopaedics and Traumatology

Abstract

Introduction

The aim of this retrospective study is to present results and complications in trauma of the reverse concept without re-fixation of the tubercles because of major osteoporosis and poor quality of the cuff. We therefore ask whether clinically the patients recover a state preceding the trauma, what the radiologic follow-up reveals and whether the rate of complications is important.

Material and methods

Thirty-seven patients, with a mean age of 75 years (range, 58–92), were included in the study. The average follow-up time was 7.3 years with a minimum of 1 year (range, 1–17).

Results

Seven complications occurred in seven patients leading to five reoperations. The mean Constant score was 53 points at last revision, representing 67 % of the mean score of the uninjured side. The mean adjusted Constant score was 68 %. Forty-two percent of the patients were unsatisfied because of poor rotations. Radiological abnormalities were: 2 patients had complete borders between the base plate and the glenoid, 14 had inferior spurs which did not affect function and 21 inferior scapular notches including 10 with associated medial proximal humeral bone loss and radiolucent lines between the bone cement border and the humerus. Notching increased in size with longer follow-up and there was a relationship in the decrease of the Constant score (41) in cases of notching accompanied by proximal humerus alterations.

Discussion and conclusion

Functional results were not equal to the pre-injury state. When the dominant arm was affected, the patients lost their autonomy. Forty-eight percent of the radiological findings were worrying. Nineteen percent of the patients had a severe complication.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Neer CS II (1970) Displaced proximal humeral fractures. Part II. Treatment of three-part and four-part displacement. J Bone Joint Surg Am 52:1090–1103

    PubMed  Google Scholar 

  2. Tanner MW, Cofield RH (1983) Prosthetic arthroplasty for fractures and fracture-dislocations of the proximal humerus. Clin Orthop Relat Res 179:116–128

    Article  PubMed  Google Scholar 

  3. Boileau P, Krishanan SG, Tinsi L et al (2002) Tuberosity malposition and migration: reasons for poor outcome after hemiarthroplasty for displaced fractures of the proximal humerus. J Shoulder Elbow Surg 11:401–412

    Article  PubMed  CAS  Google Scholar 

  4. Post M, Haskell SS, Jablon M (1980) Total shoulder replacement with a constrained prosthesis. J Bone Joint Surg Am 62:327–335

    PubMed  CAS  Google Scholar 

  5. Boileau P, Watkinson DJ, Hatzidakis AM et al (2005) Grammont reverse prosthesis: design, rationale and biomechanics. J Shoulder Elbow Surg 14:147S–161S

    Article  PubMed  Google Scholar 

  6. Bufquin T, Hersan A, Hubert L (2007) Reversed shoulder arthroplasty for the treatment of three- and four-part fractures of the proximal humerus in elderly. A prospective review of 43 cases with a short-term follow-up. J Bone Joint Surg Br 89:516–520

    Article  PubMed  CAS  Google Scholar 

  7. Klein M, Juschka M, Hinkenjann B et al (2008) Treatment of comminuted fractures of the proximal humerus in elderly patients with the Delta III reverse shoulder prosthesis. J Orthop Trauma 22:698–704

    Article  PubMed  Google Scholar 

  8. Wall B, Walch G (2007) Reverse shoulder arthroplasty for treatment of proximal humeral fractures. Hand Clin 23:425–430

    Article  PubMed  Google Scholar 

  9. Kontakis G, Tosounidis T, Galanakis I et al (2008) Prosthetic replacement for proximal humeral fractures. Injury 39:1345–1358

    Article  PubMed  Google Scholar 

  10. Gallinet D, Clappaz P, Garbuio Y et al (2009) Three or four parts complex proximal humerus fractures: hemiarthroplasty versus reverse prosthesis: a comparative study of 40 cases. Orthop Traum: Surg and Res 95:48–55

    Article  CAS  Google Scholar 

  11. Neer CS II (1970) Displaced proximal humerus fractures. Part I. Classification and evaluation. J Bone Joint Surg Am 52:1077–1089

    PubMed  Google Scholar 

  12. Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164

    PubMed  Google Scholar 

  13. Valenti P, Boutens D, Nérot C (2001) Delta 3 reversed prosthesis for osteoarthritis with massive rotator cuff tear: long term results. In: Walch G, Molé D (eds) 2000 shoulders prostheses. Two to ten years follow-up. Sauramps Medical, Montpellier, pp 253–259

    Google Scholar 

  14. Cazeneuve JF, Cristofari DJ (2010) The reverse shoulder arthroplasty in the treatment of fractures of the proximal humerus fractures. J Bone Joint Surg Br 92:535–539

    Article  PubMed  CAS  Google Scholar 

  15. Tisher T, Rose T, Imhoff AB (2008) The reverse shoulder prosthesis for primary and secondary treatment of proximal humeral fractures: a case report. Arch Orthop Trauma Surg 128:973–978

    Article  Google Scholar 

  16. Gerber C, Pennington SD, Lingenfelter EJ (2007) Reverse Delta III total shoulder replacement combined with latissimus dorsi transfer. A preliminary report. J Bone Joint Surg Am 89:940–947

    Article  PubMed  Google Scholar 

  17. Frankle M, Siegal S, Pupello D et al (2005) The reverse shoulder prosthesis for glenohumeral arthritis associated with severe rotator cuff deficiency. A minimum two-year follow-up study of sixty patients. J Bone Joint Surg Am 87:1697–1705

    Article  PubMed  Google Scholar 

  18. Resch H, Povacz P, Ritter E et al (2000) Transfer of pectoralis major muscle for the treatment of irreparable rupture of the subscapularis tendon. J Bone Joint Surg Am 82:375–384

    Article  Google Scholar 

  19. Gutiérrez S, Levy JC, Leen WE et al (2007) Center of rotation affects abduction range of motion of reverse shoulder arthroplasty. Clin Orthop 458:78–82

    PubMed  Google Scholar 

  20. Gutiérrez S, Comiskey C, Luo ZP et al (2008) Range of impingement-free abduction and adduction deficit after reverse shoulder arthroplasty. Hierarchy of surgical and implant-design-related factors. J Bone Joint Surg Am 90:2606–2615

    Article  PubMed  Google Scholar 

  21. Cazeneuve JF, Cristofari DJ (2009) Delta III reverse shoulder arthroplasty radiological outcome for acute complex fractures of the proximal humerus in elderly patients. Orthop Traum Surg and Res 95:325–329

    Article  Google Scholar 

  22. Boileau P, Watkinson D, Hatzidakis A et al (2006) Neer Award 2005: the Grammont reverse shoulder prosthesis: results in cuff tear arthritis, fracture sequelae, and revision arthroplasty. J Shoulder Elbow Surg 15:527–540

    Article  PubMed  Google Scholar 

  23. Werner CM, Steinmann PA, Gilbart M et al (2005) Treatment of painful pseudopareis due to irreparable rotator cuff dysfunction with reverse-ball-and-socket total shoulder prosthesis. J Bone Joint Surg Am 87:1476–1486

    Article  PubMed  CAS  Google Scholar 

  24. Guitérrez S, Greiwe RM, Frankle MA et al (2007) Biomechanical comparison of component position and hardware failure in the reverse shoulder prosthesis. J Shoulder Elbow Surg 16(3 Suppl):S9–S12

    Article  Google Scholar 

  25. Sirveaux F, Favard L, Oudet D et al (2004) Grammont inverted total shoulder arthroplasty in treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Joint Surg Br 86:388–395

    Article  PubMed  CAS  Google Scholar 

  26. Nyffeler RW, Werner CM, Simmen BR et al (2004) Analysis of a retrieved Delta III total shoulder prosthesis. J Bone Joint Surg Br 86:1187–1191

    Article  PubMed  CAS  Google Scholar 

  27. Nyffeler RW, Werner CM, Gerber C (2005) Biomechanical relevance of glenoid component positioning in the reverse Delta III total shoulder prosthesis. J Shoulder Elbow Surg 14:524–528

    Article  PubMed  Google Scholar 

  28. Sirveaux F, Navez G, Roche O et al (2008) Reverse prosthesis for proximal humeral fracture, technique and results. Techn in Should and Elb Surg 9:15–22

    Article  Google Scholar 

  29. Sirveaux F, Roche O, Molé D (2010) Shoulder arthroplasty for acute proximal humerus fracture. Orthop Trauma: Surg and Res 96:748–760

    Article  Google Scholar 

Download references

Acknowledgments

The authors thank Professor Levon Doursounian, Department of Orthopaedics, Saint-Antoine Hospital, Paris, France for his help in clinical and radiological revisions and his precious advice.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Centre Hospitalier, Laon, 02000, France

    Jean-François Cazeneuve, Yasser Hassan, Abdallah Hilaneh, Ferhat Kermad & Alain Brunel

Authors
  1. Jean-François Cazeneuve
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yasser Hassan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Abdallah Hilaneh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ferhat Kermad
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alain Brunel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jean-François Cazeneuve.

Additional information

Level of Evidence: Level III, Retrospective study.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cazeneuve, JF., Hassan, Y., Hilaneh, A. et al. Does the reverse shoulder arthroplasty durably restore function in trauma?. Eur Orthop Traumatol 3, 221–226 (2012). https://doi.org/10.1007/s12570-012-0137-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12570-012-0137-3

Keywords

Search

Navigation