Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
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Reverse total shoulder replacement for patients with "weight-bearing" shoulders

  • Ofer Levy (The Reading Shoulder Unit, Berkshire Independent Hospital) ;
  • Georgios Arealis (The Reading Shoulder Unit, Berkshire Independent Hospital) ;
  • Oren Tsvieli (The Reading Shoulder Unit, Berkshire Independent Hospital) ;
  • Paolo Consigliere (The Reading Shoulder Unit, Berkshire Independent Hospital) ;
  • Omri Lubovsky (Faculty of Health Sciences, Ben-Gurion University of the Negev)
  • 투고 : 2023.06.25
  • 심사 : 2023.11.23
  • 발행 : 2024.06.01
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초록

Background: Reverse total shoulder arthroplasty (rTSA) has gained popularity in recent years and is indicated for a wide variety of shoulder pathologies. However, use of rTSA in patients with "weight-bearing" shoulders that support wheelchair use or crutches has higher risk. The aim of this study was to assess the results of rTSA in such patients. Methods: Between 2005 and 2014, 24 patients (30 shoulders) with weight-bearing shoulders were treated with rTSA at our unit. Patients had cuff arthropathy (n=21), rheumatoid arthritis (n=3), osteoarthritis (n=1), acute fracture (n=3), or fracture sequela (n=2). Postoperatively, patients were advised not to push themselves up and out of their wheelchair for 6 weeks. This study was performed in 2016, and 21 patients (27 shoulders) were available for a mean follow-up of 5.6 years (range, 2-10 years). The mean age at surgery was 78 years (range, 54-90 years). Results: Constant-Murley score improved from 9.4 preoperatively to 59.8 at the final follow-up (P=0.001). Pain score improved from 2/15 to 13.8/15 (P=0.001). Patient satisfaction (Subjective Shoulder Value) improved from 0.6/10 to 8.7/10 (P=0.001). Significant improvement in mean range of motion from 46° to 130° of elevation, 14° to 35° of external rotation, and 29° to 78° internal rotation was recorded (P=0.001). Final mean Activities of Daily Living External and Internal Rotation was 32.4/36. Only three patients showed Sirveaux-Nerot grade-1 (10%) glenoid notching and three grade 2 (10%). Conclusions: rTSA can be used for treatment of patients with weight-bearing shoulders. Such patients reported pain free movement, resumed daily activities, and high satisfaction rates.

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참고문헌

  1. Bayley JC, Cochran TP, Sledge CB. The weight-bearing shoulder: the impingement syndrome in paraplegics. J Bone Joint Surg Am 1987;69:676-8.
  2. Jain NB, Higgins LD, Katz JN, Garshick E. Association of shoulder pain with the use of mobility devices in persons with chronic spinal cord injury. PM R 2010;2:896-900.
  3. Gellman H, Sie I, Waters RL. Late complications of the weight-bearing upper extremity in the paraplegic patient. Clin Orthop Relat Res 1988;132-5.
  4. Gutierrez DD, Thompson L, Kemp B, Mulroy SJ, Physical Therapy Clinical Research Network; Rehabilitation Research and Training Center on Aging-Related Changes in Impairment for Persons Living with Physical Disabilities. The relationship of shoulder pain intensity to quality of life, physical activity, and community participation in persons with paraplegia. J Spinal Cord Med 2007;30:251-5.
  5. van Drongelen S, van der Woude LH, Veeger HE. Load on the shoulder complex during wheelchair propulsion and weight relief lifting. Clin Biomech (Bristol, Avon) 2011;26:452-7.
  6. Garreau De Loubresse C, Norton MR, Piriou P, Walch G. Replacement arthroplasty in the weight-bearing shoulder of paraplegic patients. J Shoulder Elbow Surg 2004;13:369-72.
  7. Nawoczenski DA, Clobes SM, Gore SL, et al. Three-dimensional shoulder kinematics during a pressure relief technique and wheelchair transfer. Arch Phys Med Rehabil 2003;84:1293-300.
  8. Nawoczenski DA, Riek LM, Greco L, Staiti K, Ludewig PM. Effect of shoulder pain on shoulder kinematics during weight-bearing tasks in persons with spinal cord injury. Arch Phys Med Rehabil 2012;93:1421-30.
  9. Morrow MM, Kaufman KR, An KN. Scapula kinematics and associated impingement risk in manual wheelchair users during propulsion and a weight relief lift. Clin Biomech (Bristol, Avon) 2011;26:352-7.
  10. Gutierrez S, Greiwe RM, Frankle MA, Siegal S, Lee WE. Biomechanical comparison of component position and hardware failure in the reverse shoulder prosthesis. J Shoulder Elbow Surg 2007;16(3 Suppl):S9-12.
  11. Kemp AL, King JJ, Farmer KW, Wright TW. Reverse total shoulder arthroplasty in wheelchair-dependent patients. J Shoulder Elbow Surg 2016;25:1138-45.
  12. Levy O, Mullett H, Roberts S, Copeland S. The role of anterior deltoid reeducation in patients with massive irreparable degenerative rotator cuff tears. J Shoulder Elbow Surg 2008;17:863-70.
  13. Huskisson EC. Measurement of pain. Lancet 1974;2:1127-31.
  14. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 1987;160-4.
  15. Gilbart MK, Gerber C. Comparison of the subjective shoulder value and the Constant score. J Shoulder Elbow Surg 2007;16:717-21.
  16. Williams GN, Gangel TJ, Arciero RA, Uhorchak JM, Taylor DC. Comparison of the Single Assessment Numeric Evaluation method and two shoulder rating scales. Outcomes measures after shoulder surgery. Am J Sports Med 1999;27:214-21.
  17. Boileau P, Chuinard C, Roussanne Y, Neyton L, Trojani C. Modified latissimus dorsi and teres major transfer through a single delto-pectoral approach for external rotation deficit of the shoulder: as an isolated procedure or with a reverse arthroplasty. J Shoulder Elbow Surg 2007;16:671-82.
  18. Boileau P, Chuinard C, Roussanne Y, Bicknell RT, Rochet N, Trojani C. Reverse shoulder arthroplasty combined with a modified latissimus dorsi and teres major tendon transfer for shoulder pseudoparalysis associated with dropping arm. Clin Orthop Relat Res 2008;466:584-93.
  19. Levy O, Walecka J, Arealis G, et al. Bilateral reverse total shoulder arthroplasty-functional outcome and activities of daily living. J Shoulder Elbow Surg 2017;26:e85-96.
  20. Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Mole D. Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Joint Surg Br 2004;86:388-95.
  21. Jung HJ, Sim GB, Jeon IH, Kekatpure AL, Sun JH, Chun JM. Reconstruction of rotator cuff tears in wheelchair-bound paraplegic patients. J Shoulder Elbow Surg 2015;24:601-5.
  22. Westerhoff P, Graichen F, Bender A, et al. In vivo measurement of shoulder joint loads during activities of daily living. J Biomech 2009;42:1840-9.
  23. Westerhoff P, Graichen F, Bender A, et al. Measurement of shoulder joint loads during wheelchair propulsion measured in vivo. Clin Biomech (Bristol, Avon) 2011;26:982-9.
  24. Westerhoff P, Graichen F, Bender A, et al. In vivo measurement of shoulder joint loads during walking with crutches. Clin Biomech (Bristol, Avon) 2012;27:711-8.
  25. Van Drongelen S, Van der Woude LH, Janssen TW, Angenot EL, Chadwick EK, Veeger DH. Mechanical load on the upper extremity during wheelchair activities. Arch Phys Med Rehabil 2005;86:1214-20.
  26. Middleton C, Uri O, Phillips S, et al. A reverse shoulder arthroplasty with increased offset for the treatment of cuff-deficient shoulders with glenohumeral arthritis. Bone Joint J 2014;96-936-42.
  27. Ackland DC, Patel M, Knox D. Prosthesis design and placement in reverse total shoulder arthroplasty. J Orthop Surg Res 2015;10:101.
  28. Lawrence C, Williams GR, Namdari S. Influence of glenosphere design on outcomes and complications of reverse arthroplasty: a systematic review. Clin Orthop Surg 2016;8:288-97.
  29. Grammont PM, Baulot E. Delta shoulder prosthesis for rotator cuff rupture. Orthopedics 1993;16:65-8.
  30. Khan WS, Longo UG, Ahrens PM, Denaro V, Maffulli N. A systematic review of the reverse shoulder replacement in rotator cuff arthropathy, rotator cuff tears, and rheumatoid arthritis. Sports Med Arthrosc Rev 2011;19:366-79.
  31. Jobin CM, Galdi B, Anakwenze OA, Ahmad CS, Levine WN. Reverse shoulder arthroplasty for the management of proximal humerus fractures. J Am Acad Orthop Surg 2015;23:190-201.
  32. Cicak N, Klobucar H, Medancic N. Reverse shoulder arthroplasty in acute fractures provides better results than in revision procedures for fracture sequelae. Int Orthop 2015;39:343-8.
  33. Farshad M, Gerber C. Reverse total shoulder arthroplasty-from the most to the least common complication. Int Orthop 2010;34:1075-82.
  34. Zumstein MA, Pinedo M, Old J, Boileau P. Problems, complications, reoperations, and revisions in reverse total shoulder arthroplasty: a systematic review. J Shoulder Elbow Surg 2011; 20:146-57.
  35. Hopkins AR, Hansen UN. Primary stability in reversed-anatomy glenoid components. Proc Inst Mech Eng H 2009;223:805-12.
  36. Levy O, Narvani A, Hous N, et al. Reverse shoulder arthroplasty with a cementless short metaphyseal humeral implant without a stem: clinical and radiologic outcomes in prospective 2- to 7-year follow-up study. J Shoulder Elbow Surg 2016;25:1362-70.