Midterm outcomes of primary reverse shoulder arthroplasty: a systematic review of studies with minimum 5-year follow-up
Background: Excellent short-term outcomes after reverse shoulder arthroplasty (RSA) have been reported, but longer term outcomes in the existing literature are sparse and vary widely. The purpose of this study is to systematically assess the existing literature to quantify functional outcomes and co...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-02-01
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| Series: | JSES Reviews, Reports, and Techniques |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666639123000871 |
| _version_ | 1797339162273120256 |
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| author | Tom R. Doyle, Mb, BCh Sophia Downey Eoghan T. Hurley, MCh, PhD Christopher Klifto, MD Hannan Mullett, MCh, FRCS Patrick J. Denard, MD Grant E. Garrigues, MD Mariano E. Menendez, MD |
| author_facet | Tom R. Doyle, Mb, BCh Sophia Downey Eoghan T. Hurley, MCh, PhD Christopher Klifto, MD Hannan Mullett, MCh, FRCS Patrick J. Denard, MD Grant E. Garrigues, MD Mariano E. Menendez, MD |
| author_sort | Tom R. Doyle, Mb, BCh |
| collection | DOAJ |
| description | Background: Excellent short-term outcomes after reverse shoulder arthroplasty (RSA) have been reported, but longer term outcomes in the existing literature are sparse and vary widely. The purpose of this study is to systematically assess the existing literature to quantify functional outcomes and complication rates after RSA at a minimum of five years of follow-up. Methods: A Preferred Reporting Items for Systematic Reviews and Meta-analyses-compliant systematic literature search of the PubMed and Embase databases was undertaken. Studies reporting outcomes after primary RSA for nontrauma-related indications with a minimum of 5-year follow-up were included. Results: Overall, 20 studies satisfied all inclusion criteria. This represented 1591 shoulders in 1556 patients (32.1% males), with a mean age of 70.2 ± 5.0 years and mean follow-up of 8.8 years, or 106.2 ± 30.1 months (60-243). At final follow-up, the mean reported Constant Murley score was 62.1 ± 5.0 (49.0-83.0). The mean adjusted Constant Murley score was 83.5 ± 12.5 (58-111.9). The mean American Shoulder and Elbow Surgeons score was 81.8 ± 4.6, while the mean subjective shoulder value was 74.6 ± 6.4. Overall, 88% of patients rated their satisfaction as either good or very good. The range of active forward flexion, abduction, external, and internal rotation were respectively, 126° ± 13°, 106° ± 11°, 22° ± 11°, and 6° ± 2°. The overall rate of revision surgery was 4.9% (0%-45.5%). Regarding complications, the rate of prosthetic joint infection was 4.3% (0%-26.7%), shoulder dislocation was 3.7% (0%-20.4%), and acromial fracture was 2.0% (0%-8.8%). At final follow-up, 30.9% of shoulders had some degree of scapular notching. Conclusion: This systematic review shows that RSA results in high satisfaction rates, good clinical outcomes, as well as modest complication and revision rates at minimum 5-year follow-up. |
| first_indexed | 2024-03-08T09:41:58Z |
| format | Article |
| id | doaj.art-9962a6ca53564c8587244c51fe4ba9e4 |
| institution | Directory Open Access Journal |
| issn | 2666-6391 |
| language | English |
| last_indexed | 2024-03-08T09:41:58Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES Reviews, Reports, and Techniques |
| spelling | doaj.art-9962a6ca53564c8587244c51fe4ba9e42024-01-30T04:18:00ZengElsevierJSES Reviews, Reports, and Techniques2666-63912024-02-014117Midterm outcomes of primary reverse shoulder arthroplasty: a systematic review of studies with minimum 5-year follow-upTom R. Doyle, Mb, BCh0Sophia Downey1Eoghan T. Hurley, MCh, PhD2Christopher Klifto, MD3Hannan Mullett, MCh, FRCS4Patrick J. Denard, MD5Grant E. Garrigues, MD6Mariano E. Menendez, MD7Sports Surgery Clinic, Dublin, Ireland; Department of Surgery, University of Galway, Galway, Ireland; Corresponding author: Tom R. Doyle, MB, BCh, Sports Surgery Clinic, Santry, Dublin 9, Dublin, Ireland.Royal College of Surgeons in Ireland, Dublin, IrelandDepartment of Orthopaedics, Duke University, Durham, NC, USADepartment of Orthopaedics, Duke University, Durham, NC, USASports Surgery Clinic, Dublin, IrelandOregon Shoulder Institute, Medford, OR, USADepartment of Orthopaedics, Rush University, Chicago, IL, USAOregon Shoulder Institute, Medford, OR, USABackground: Excellent short-term outcomes after reverse shoulder arthroplasty (RSA) have been reported, but longer term outcomes in the existing literature are sparse and vary widely. The purpose of this study is to systematically assess the existing literature to quantify functional outcomes and complication rates after RSA at a minimum of five years of follow-up. Methods: A Preferred Reporting Items for Systematic Reviews and Meta-analyses-compliant systematic literature search of the PubMed and Embase databases was undertaken. Studies reporting outcomes after primary RSA for nontrauma-related indications with a minimum of 5-year follow-up were included. Results: Overall, 20 studies satisfied all inclusion criteria. This represented 1591 shoulders in 1556 patients (32.1% males), with a mean age of 70.2 ± 5.0 years and mean follow-up of 8.8 years, or 106.2 ± 30.1 months (60-243). At final follow-up, the mean reported Constant Murley score was 62.1 ± 5.0 (49.0-83.0). The mean adjusted Constant Murley score was 83.5 ± 12.5 (58-111.9). The mean American Shoulder and Elbow Surgeons score was 81.8 ± 4.6, while the mean subjective shoulder value was 74.6 ± 6.4. Overall, 88% of patients rated their satisfaction as either good or very good. The range of active forward flexion, abduction, external, and internal rotation were respectively, 126° ± 13°, 106° ± 11°, 22° ± 11°, and 6° ± 2°. The overall rate of revision surgery was 4.9% (0%-45.5%). Regarding complications, the rate of prosthetic joint infection was 4.3% (0%-26.7%), shoulder dislocation was 3.7% (0%-20.4%), and acromial fracture was 2.0% (0%-8.8%). At final follow-up, 30.9% of shoulders had some degree of scapular notching. Conclusion: This systematic review shows that RSA results in high satisfaction rates, good clinical outcomes, as well as modest complication and revision rates at minimum 5-year follow-up.http://www.sciencedirect.com/science/article/pii/S2666639123000871Shoulder arthroplastyReverse shoulder arthroplastySystematic reviewRotator cuff arthropathyIrreparable rotator cuff tearPatient reported outcome measures |
| spellingShingle | Tom R. Doyle, Mb, BCh Sophia Downey Eoghan T. Hurley, MCh, PhD Christopher Klifto, MD Hannan Mullett, MCh, FRCS Patrick J. Denard, MD Grant E. Garrigues, MD Mariano E. Menendez, MD Midterm outcomes of primary reverse shoulder arthroplasty: a systematic review of studies with minimum 5-year follow-up JSES Reviews, Reports, and Techniques Shoulder arthroplasty Reverse shoulder arthroplasty Systematic review Rotator cuff arthropathy Irreparable rotator cuff tear Patient reported outcome measures |
| title | Midterm outcomes of primary reverse shoulder arthroplasty: a systematic review of studies with minimum 5-year follow-up |
| title_full | Midterm outcomes of primary reverse shoulder arthroplasty: a systematic review of studies with minimum 5-year follow-up |
| title_fullStr | Midterm outcomes of primary reverse shoulder arthroplasty: a systematic review of studies with minimum 5-year follow-up |
| title_full_unstemmed | Midterm outcomes of primary reverse shoulder arthroplasty: a systematic review of studies with minimum 5-year follow-up |
| title_short | Midterm outcomes of primary reverse shoulder arthroplasty: a systematic review of studies with minimum 5-year follow-up |
| title_sort | midterm outcomes of primary reverse shoulder arthroplasty a systematic review of studies with minimum 5 year follow up |
| topic | Shoulder arthroplasty Reverse shoulder arthroplasty Systematic review Rotator cuff arthropathy Irreparable rotator cuff tear Patient reported outcome measures |
| url | http://www.sciencedirect.com/science/article/pii/S2666639123000871 |
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