Abstract
Background
Reverse Total Shoulder Arthroplasty is commonly performed for elective indications, such as cuff tear arthropathies, salvage arthropathies and tumours with excellent outcomes. However, its use in treating acute conditions such as 3- and 4-part proximal humeral fractures in the elderly has been more controversial. The aim of our study is to directly compare the short-term intra-operative and post-operative outcomes of RTSA for traumatic proximal humeral fractures as compared to elective shoulder arthroplasty.
Methods
We retrospectively identified 78 consecutive patients who had undergone RTSA from 2009 to 2018 at a tertiary hospital. These patients were classified by etiology as either elective or trauma cases. Comparative analysis of the baseline demographics, as well as post-operative surgical, functional and range-of-movement outcomes between the two groups was performed.
Results
57 Patients made up the elective cohort and 14 patients made up the trauma cohort. The elective cohort was significantly older compared to the traumatic fracture cohort (73.2 vs 78.6, p = 0.026). No significant differences were observed when comparing post-operative surgical outcomes. At 6 months, the elective cohort demonstrated greater forward flexion (105.8° vs 127.2°, p = 0.041), as well as higher SF-36 PCS (27.85 vs 43.99, p = 0.018) and ASES scores (35.5 vs 76.31, p = 0.009). However, these differences resolved by 1-year post-op and no significant differences were noted comparing functional and range-of-movement outcomes at 1-year post-op.
Conclusions
Our study suggests that the application of reverse total shoulder arthroplasty in the management of traumatic humeral fractures may produce similarly favourable 1-year outcomes to that performed for elective etiologies.
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Study approved by local ethics board (DSRB 2019/00057).
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Glen, L.Z.Q., Cheong, C.K., Nistala, K.R.Y. et al. Outcomes of Reverse Total Shoulder Arthroplasties Performed for Proximal Humeral Fractures Versus Elective Etiologies. JOIO 56, 1066–1072 (2022). https://doi.org/10.1007/s43465-022-00625-4
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DOI: https://doi.org/10.1007/s43465-022-00625-4