The modern reverse shoulder arthroplasty and an updated systematic review for each complication: part I
Year: 2020
Type: review
Study design: Systematic Review
Abstract: Background Globally, reverse shoulder arthroplasty (RSA) has moved away from the Grammont design to modern prosthesis designs. The purpose of this 2-part study was to systematically review each of the most common complications of RSA, limiting each search to publications in 2010 or later. In this part (part I), we examined (1) scapular notching (SN), (2) periprosthetic infection (PJI), (3) mechanical failure (glenoid or humeral component), and (4) neurologic injury (NI). Methods Four separate PubMed database searches were performed following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Overall, 113 studies on SN, 62 on PJI, 34 on mechanical failure, and 48 on NI were included in our reviews. Univariate analysis was performed with the χ 2 or Fisher exact test. Results The Grammont design had a higher SN rate vs. all other designs combined (42.5% vs. 12.3%, P < .001). The onlay humeral design had a lower rate than the lateralized glenoid design (10.5% vs. 14.8%, P < .001). The PJI rate was 2.4% for primary RSA and 2.6% for revision RSA. The incidence of glenoid and humeral component loosening was 2.3% and 1.4%, respectively. The Grammont design had an increased NI rate vs. all other designs combined (0.9% vs. 0.1%, P = .04). Conclusions Focused systematic reviews of the recent literature with a large volume of RSAs demonstrate that with the use of non-Grammont modern prosthesis designs, complications including SN, PJI, glenoid component loosening, and NI are significantly reduced compared with previous studies. As the indications for RSA continue to expand, it is imperative to accurately track the rates and types of complications to justify its cost and increased indications.
Source: JSES International
Authors: Sarav S. Shah, Benjamin T. Gaal, Alexander M. Roche, Surena Namdari, Brian M. Grawe, Macy Lawler, Stewart Dalton, Joseph J. King, Joshua Helmkamp, Grant E. Garrigues, Thomas W. Wright, Bradley S. Schoch, Kyle Flik, Randall J. Otto, Richard Jones, Andrew Jawa, Peter McCann, Joseph Abboud, Gabe Horneff, Glen Ross, Richard Friedman, Eric T. Ricchetti, Douglas Boardman, Robert Z. Tashjian, Lawrence V. Gulotta
Institution: American Shoulder and Elbow Surgeons
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,250
OpenAlex ID: W4235587872