TY - JOUR
T1 - Risk factors of instability following reverse total shoulder arthroplasty in patients with no history of shoulder surgery
AU - Sinkler, Margaret A.
AU - Dolan, Joshua D.
AU - Henderson, Drew
AU - Steflik, Michael J.
AU - Lewis, Frank D.
AU - Parada, Stephen A.
AU - Crosby, Lynn A
N1 - Funding Information:
None.☆ No additional sources of funding for research and/or publication.
Publisher Copyright:
© 2022 Professor P K Surendran Memorial Education Foundation
PY - 2022/11/1
Y1 - 2022/11/1
N2 - Introduction: As its indications expand, reverse total shoulder arthroplasty (rTSA) utilization continues to increase. Though relatively uncommon, instability following rTSA can be associated with significant morbidity and need for subsequent revision and treatment. This case control study aims to characterize factors leading to instability after rTSA, especially in those with no previous shoulder surgery. Methods: 194 rTSAs performed within the study period with appropriate operative indications and follow-up were included. Risk factors used in analysis included age, gender, BMI, ASA class, Charlson comorbidity index (CCI), glenosphere, tray, and liner size. Data was analyzed using a hierarchical binary logistical regression to create a predictive model for instability. Results: Seven patients sustained a post-operative dislocation. Mean time to dislocation was 60.4 weeks. Five required open reduction with placement of either a larger humeral tray or polyethylene spacer. One required open reduction with osteophyte removal, and one was converted to a resection arthroplasty. Dislocators were more likely to have a larger BMI (p = 0.002), higher ASA classification (p = 0.09), and larger liner size (p = 0.01). Conclusion: This study demonstrates a large series of patients successfully treated with rTSA. Dislocations were an uncommon complication, but were clearly associated with higher patient BMI, ASA classification, and increased liner size.
AB - Introduction: As its indications expand, reverse total shoulder arthroplasty (rTSA) utilization continues to increase. Though relatively uncommon, instability following rTSA can be associated with significant morbidity and need for subsequent revision and treatment. This case control study aims to characterize factors leading to instability after rTSA, especially in those with no previous shoulder surgery. Methods: 194 rTSAs performed within the study period with appropriate operative indications and follow-up were included. Risk factors used in analysis included age, gender, BMI, ASA class, Charlson comorbidity index (CCI), glenosphere, tray, and liner size. Data was analyzed using a hierarchical binary logistical regression to create a predictive model for instability. Results: Seven patients sustained a post-operative dislocation. Mean time to dislocation was 60.4 weeks. Five required open reduction with placement of either a larger humeral tray or polyethylene spacer. One required open reduction with osteophyte removal, and one was converted to a resection arthroplasty. Dislocators were more likely to have a larger BMI (p = 0.002), higher ASA classification (p = 0.09), and larger liner size (p = 0.01). Conclusion: This study demonstrates a large series of patients successfully treated with rTSA. Dislocations were an uncommon complication, but were clearly associated with higher patient BMI, ASA classification, and increased liner size.
KW - Arthroplasty, Replacement, Shoulder
KW - Comorbidity
KW - Dislocation
KW - Exactech equinoxe
KW - Operative instability
KW - Retrospective studies
KW - Risk factors
KW - Shoulder
KW - Shoulder prosthesis
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U2 - 10.1016/j.jor.2022.09.018
DO - 10.1016/j.jor.2022.09.018
M3 - Article
AN - SCOPUS:85139052327
SN - 0972-978X
VL - 34
SP - 339
EP - 343
JO - Journal of Orthopaedics
JF - Journal of Orthopaedics
ER -