Skip to main content
SpringerLink
Log in

Periprosthetic humeral fractures associated with reverse total shoulder arthroplasty: incidence and management

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to record the incidence and management of periprosthetic humeral fractures (PHF) using reverse total shoulder arthroplasty (RTSA) in our institution.

Methods

We performed a retrospective study of 203 RTSA implanted in 200 patients between 2003 and 2014. The mean follow-up was 78.82 months (range, 12–141). Mean age of the study cohort was 75.87 years (range, 44–88). There were only 25 male patients (12.5 %). We assessed the presence of periprosthetic humeral fractures studying the medical files and X-rays of all patients.

Results

We identified seven periprosthetic humeral fractures in 203 RTSA (3.4 %): three intra-operative (1.47 %) and four post-operative (1.97 %). The average age at the time of the fracture was 75.14 years (59–83). All patients were women (100 %). Three patients with post-operative fractures type B were treated by osteosynthesis, and one patient with post-operative fracture type A was treated conservatively. All intra-operative fractures needed cerclage wire and in one case long cemented stem. All our periprosthetic fractures healed.

Conclusions

Surgical treatment with osteosynthesis in type B post-operative fractures with a stable stem is recommended. Conservative treatment is sufficient in non-displaced type A post-operative fracture. Special attention should be paid to bone quality patients using non-cemented stems in primary surgery but especially in revision shoulder surgery.

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

Similar content being viewed by others

References

  1. Baulot E, Sirveaux F, Boileau P (2011) Grammont’s idea. The story of Paul Grammont’s functional surgery concept and the development of the reverse principle. Clin Orthop Relat Res 469:2425–2431

    Article  PubMed Central  PubMed  Google Scholar 

  2. King JJ, Farmer KW, Struk AM, Wright TW (2015) Uncemented versus cemented humeral stem fixation in reverse shoulder arthroplasty. Int Orthop 39:291–298

    Article  PubMed  Google Scholar 

  3. Sirveaux F, Favard L, Oudet et al (2004) Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicenter study of 80 shoulders. J Bone Joint Surg (Br) 86(3):388–395

    Article  CAS  Google Scholar 

  4. Chin PYK, Sperling JW, Cofield RH et al (2006) Complications of total shoulder arthroplasty: are they fewer or different. J Should Elb Surg 15:19–22

    Article  Google Scholar 

  5. Farshad M, Gerber C (2010) Reverse total shoulder arthroplasty-from the most to the least common complication. Int Orthop 34:1075–1082

    Article  PubMed Central  PubMed  Google Scholar 

  6. Affonso J, Nicholson GP, Frankle MA et al (2012) Complications of the reverse prosthesis: prevention and treatment. Instr Course Lect 61:157–168

    PubMed  Google Scholar 

  7. Cheung E, Willis M, Walker M et al (2011) Complications in reverse total shoulder arthroplasty. J Am Acad Orthop Surg 19:439–449

    PubMed  Google Scholar 

  8. Kim SH, Wise BL, Zhang Y et al (2011) Increasing incidence of shoulder arthroplasty in the United States. J Bone Joint Surg Am 93:2249–2254

    PubMed  Google Scholar 

  9. Kumar S, Sperling JW, Haidukewych GH et al (2004) Periprosthetic humeral fractures after shoulder arthroplasty. J Bone Joint Surg Am 86:680–689

    PubMed  Google Scholar 

  10. Luque R, Rizo B, Urda A et al (2014) Predictive factors for failure after total knee replacement revision. Int Orthop 38:429–435

    Article  PubMed Central  PubMed  Google Scholar 

  11. Athwal GS, Sperling JW, Rispoli DM et al (2009) Periprosthetic humeral fractures during shoulder arthroplasty. J Bone Joint Surg Am 91:594–603

    Article  PubMed  Google Scholar 

  12. Bohsali KI, Wirth MA, Rockwood CA Jr (2006) Complications of total shoulder arthroplasty. J Bone Joint Surg Am 88(10):2279–2292

    Article  PubMed  Google Scholar 

  13. Wright TW, Cofield RH (1995) Humeral fractures after shoulder arthroplasty. J Bone Joint Surg Am 77:1340–1346

    CAS  PubMed  Google Scholar 

  14. Campbell JT, Moore RS, Iannotti JP et al (1998) Periprosthetic humeral fractures: mechanisms of fracture and treatment options. J Should Elb Surg 7:406–413

    Article  CAS  Google Scholar 

  15. Ji JH, Jeong JY, Song HS, Ok JH, Yang SJ, Jeon BK, Kim TG, Moon YS, Kim YS (2013) Early clinical results of reverse total shoulder arthroplasty in the Korean population. J Should Elb Surg 22:1102–1107

    Article  Google Scholar 

  16. Mineo GV, Accetta R, Franceschini M et al (2013) Management of shoulder periprosthetic fractures: our institutional experience and review of the literature. Injury 44(S1):S82–85

    Article  PubMed  Google Scholar 

  17. Zumstein MA, Pinedo M, Old J, Boileau P (2011) Problems, complications, reoperations, and revision in reverse total shoulder arthroplasty: a systematic review. J Should Elb Surg 20:146–157

    Article  Google Scholar 

  18. Wolf H, Pajenda G, Sarahrudi K (2012) Analysis of factors predicting success and failure of treatment after type B periprosthetic humeral fractures: a case series study. Eur J Trauma Emerg Surg 38:177–183

    Article  Google Scholar 

  19. Wierks C, Skolasky RL, Ji JH, McFarland EG (2009) Reverse total shoulder replacement: intraoperative and early postoperative complications. Clin Orthop Relat Res 467(1):225–234

    Article  PubMed Central  PubMed  Google Scholar 

  20. Jost PW, Dines JS, Griffith MH et al (2011) Total shoulder arthroplasty utilizing mini-stem humeral components: technique and short-term results. HSS J 7:213–217

    Article  PubMed Central  PubMed  Google Scholar 

  21. Singh JA, Sperling J, Schleck C, Harmsen W, Cofield R (2012) Periprosthetic fractures associated with primary total shoulder arthroplasty and primary humeral head replacement. J Bone Joint Surg Am 94:1777–1785

    Article  PubMed Central  PubMed  Google Scholar 

  22. Raiss P, Zeifang F, Pons-Villanueva J, Smithers CJ, Loew M, Walch G (2014) Reverse arthroplasty for osteoarthritis and rotator cuff deficiency after previous surgery for recurrent anterior shoulder instability. Int Orthop 38:1408–1413

    Google Scholar 

  23. Atoun E, Van Togel A, Hous N, Narvani A, Relwani J, Abraham R, Levy O (2014) Reverse shoulder arthroplasty with a short metaphyseal humeral stem. Int Orthop 38:1213–1218

    Article  PubMed Central  PubMed  Google Scholar 

  24. Angelini A, Battiato C (2015) Past and present of the use of cerclage wires in orthopedics. Eur J Orthop Surg Traumatol 25:623–635

    Article  PubMed  Google Scholar 

  25. Cameron B, Iannottu JP (1999) Periprosthetic of the humerus and scapula: management and prevention. Orthop Clin N Am 30:305–318

    Article  CAS  Google Scholar 

Download references

Acknowledgments

This study received no outside funding.

Conflict of interest

The authors declare they have no competing interests.

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Hospital Clínico San Carlos, Madrid, Spain

    Carlos García-Fernández, Yaiza Lópiz-Morales, Alberto Rodríguez, Luis López-Durán & Fernando Marco Martínez

Authors
  1. Carlos García-Fernández
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yaiza Lópiz-Morales
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alberto Rodríguez
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Luis López-Durán
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fernando Marco Martínez
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Carlos García-Fernández.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

García-Fernández, C., Lópiz-Morales, Y., Rodríguez, A. et al. Periprosthetic humeral fractures associated with reverse total shoulder arthroplasty: incidence and management. International Orthopaedics (SICOT) 39, 1965–1969 (2015). https://doi.org/10.1007/s00264-015-2972-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-015-2972-7

Keywords

Search

Navigation