Cargando…
Os Acromiale in Reverse Total Shoulder Arthroplasty: A Cohort Study
BACKGROUND: Increased passive deltoid tension after reverse total shoulder arthroplasty (RTSA) potentially leads to displacement or tilting of a preexisting os acromiale. PURPOSE: To analyze patients with an os acromiale who underwent RTSA and compare their outcomes and complications with a matched...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7705793/ https://www.ncbi.nlm.nih.gov/pubmed/33294474 http://dx.doi.org/10.1177/2325967120965131 |
_version_ | 1783617020139405312 |
---|---|
author | Carpeggiani, Guilherme Hodel, Sandro Götschi, Tobias Kriechling, Philipp Bösch, Marco Meyer, Dominik C. Wieser, Karl |
author_facet | Carpeggiani, Guilherme Hodel, Sandro Götschi, Tobias Kriechling, Philipp Bösch, Marco Meyer, Dominik C. Wieser, Karl |
author_sort | Carpeggiani, Guilherme |
collection | PubMed |
description | BACKGROUND: Increased passive deltoid tension after reverse total shoulder arthroplasty (RTSA) potentially leads to displacement or tilting of a preexisting os acromiale. PURPOSE: To analyze patients with an os acromiale who underwent RTSA and compare their outcomes and complications with a matched control group without an os acromiale. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: In this study, 45 shoulders in 42 patients with an os acromiale (cases) were matched to 133 patients without os acromiale (controls) who underwent RTSA between 2005 and 2016. The mean follow-up was 52 ± 32 months. Matching criteria included sex, type of surgery, duration of follow-up, and age. The Constant score (CS), Subjective Shoulder Value (SSV), and radiological outcomes were assessed postoperatively at 1-year, 2-year, and final follow-up visits. RESULTS: The mean CS, SSV, and range of motion improved from preoperative levels to the final follow-up in both groups (P < .01). Patients with an os acromiale had a relative CS of 70 ± 23 versus 76 ± 21 points (P = .15) and an SSV of 70 ± 30 versus 73 ± 24 (P = .52) compared with controls at the final follow-up visit. Patients with an os acromiale had significantly decreased active flexion of 104° ± 33° versus 114° ± 33° (P = .03) at 1 year and active abduction of 103° ± 37° versus 121° ± 38° at 2 years postoperatively (P = .02). A postoperatively painful os acromiale was found in 12 cases (27%) and spontaneously resolved in 8 cases after a mean of 33 months (range, 12-47 months; P = .04). CONCLUSION: RTSA reliably restores patient satisfaction despite the presence of an os acromiale, with a slightly impaired range of motion. Postoperative local tenderness at the os acromiale can be expected in 1 out of 4 patients, but this resolves spontaneously over time in the majority of patients. |
format | Online Article Text |
id | pubmed-7705793 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-77057932020-12-07 Os Acromiale in Reverse Total Shoulder Arthroplasty: A Cohort Study Carpeggiani, Guilherme Hodel, Sandro Götschi, Tobias Kriechling, Philipp Bösch, Marco Meyer, Dominik C. Wieser, Karl Orthop J Sports Med Article BACKGROUND: Increased passive deltoid tension after reverse total shoulder arthroplasty (RTSA) potentially leads to displacement or tilting of a preexisting os acromiale. PURPOSE: To analyze patients with an os acromiale who underwent RTSA and compare their outcomes and complications with a matched control group without an os acromiale. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: In this study, 45 shoulders in 42 patients with an os acromiale (cases) were matched to 133 patients without os acromiale (controls) who underwent RTSA between 2005 and 2016. The mean follow-up was 52 ± 32 months. Matching criteria included sex, type of surgery, duration of follow-up, and age. The Constant score (CS), Subjective Shoulder Value (SSV), and radiological outcomes were assessed postoperatively at 1-year, 2-year, and final follow-up visits. RESULTS: The mean CS, SSV, and range of motion improved from preoperative levels to the final follow-up in both groups (P < .01). Patients with an os acromiale had a relative CS of 70 ± 23 versus 76 ± 21 points (P = .15) and an SSV of 70 ± 30 versus 73 ± 24 (P = .52) compared with controls at the final follow-up visit. Patients with an os acromiale had significantly decreased active flexion of 104° ± 33° versus 114° ± 33° (P = .03) at 1 year and active abduction of 103° ± 37° versus 121° ± 38° at 2 years postoperatively (P = .02). A postoperatively painful os acromiale was found in 12 cases (27%) and spontaneously resolved in 8 cases after a mean of 33 months (range, 12-47 months; P = .04). CONCLUSION: RTSA reliably restores patient satisfaction despite the presence of an os acromiale, with a slightly impaired range of motion. Postoperative local tenderness at the os acromiale can be expected in 1 out of 4 patients, but this resolves spontaneously over time in the majority of patients. SAGE Publications 2020-11-24 /pmc/articles/PMC7705793/ /pubmed/33294474 http://dx.doi.org/10.1177/2325967120965131 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Article Carpeggiani, Guilherme Hodel, Sandro Götschi, Tobias Kriechling, Philipp Bösch, Marco Meyer, Dominik C. Wieser, Karl Os Acromiale in Reverse Total Shoulder Arthroplasty: A Cohort Study |
title | Os Acromiale in Reverse Total Shoulder Arthroplasty: A Cohort
Study |
title_full | Os Acromiale in Reverse Total Shoulder Arthroplasty: A Cohort
Study |
title_fullStr | Os Acromiale in Reverse Total Shoulder Arthroplasty: A Cohort
Study |
title_full_unstemmed | Os Acromiale in Reverse Total Shoulder Arthroplasty: A Cohort
Study |
title_short | Os Acromiale in Reverse Total Shoulder Arthroplasty: A Cohort
Study |
title_sort | os acromiale in reverse total shoulder arthroplasty: a cohort
study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7705793/ https://www.ncbi.nlm.nih.gov/pubmed/33294474 http://dx.doi.org/10.1177/2325967120965131 |
work_keys_str_mv | AT carpeggianiguilherme osacromialeinreversetotalshoulderarthroplastyacohortstudy AT hodelsandro osacromialeinreversetotalshoulderarthroplastyacohortstudy AT gotschitobias osacromialeinreversetotalshoulderarthroplastyacohortstudy AT kriechlingphilipp osacromialeinreversetotalshoulderarthroplastyacohortstudy AT boschmarco osacromialeinreversetotalshoulderarthroplastyacohortstudy AT meyerdominikc osacromialeinreversetotalshoulderarthroplastyacohortstudy AT wieserkarl osacromialeinreversetotalshoulderarthroplastyacohortstudy |