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Stem retention and survival in revision of anatomical convertible shoulder arthroplasty to reverse arthroplasty: a Dutch registry study

BACKGROUND: Convertible stem designs allow for stem retention during revision from anatomical to reverse shoulder arthroplasty. In some cases conversion is not possible for example due to excessive soft tissue tensioning. In these cases a total revision is necessary. The primary aim of this Dutch re...

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Autores principales: Theelen, Luuk M. A., Mory, Ben, Venkatesan, Sharmila, Spekenbrink-Spooren, Anneke, Janssen, Loes, Lambers Heerspink, Frederik O.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8082907/
https://www.ncbi.nlm.nih.gov/pubmed/33910540
http://dx.doi.org/10.1186/s12891-021-04247-z
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author Theelen, Luuk M. A.
Mory, Ben
Venkatesan, Sharmila
Spekenbrink-Spooren, Anneke
Janssen, Loes
Lambers Heerspink, Frederik O.
author_facet Theelen, Luuk M. A.
Mory, Ben
Venkatesan, Sharmila
Spekenbrink-Spooren, Anneke
Janssen, Loes
Lambers Heerspink, Frederik O.
author_sort Theelen, Luuk M. A.
collection PubMed
description BACKGROUND: Convertible stem designs allow for stem retention during revision from anatomical to reverse shoulder arthroplasty. In some cases conversion is not possible for example due to excessive soft tissue tensioning. In these cases a total revision is necessary. The primary aim of this Dutch registry study was to evaluate the unforeseen stem reversion percentages in revision of convertible anatomical shoulder arthroplasty to reverse shoulder arthroplasty. METHODS: Shoulder arthroplasties (n = 2834) performed between 2014 and 2016 registered in the Dutch Arthroplasty Registry were selected. In 2016 94% of primary arthroplasties and 92% of revision arthroplasties were registered in the database. Arthroplasties were selected on convertibility. Mean follow-up was 2.4 years. We analysed the number of revisions for convertible and non-convertible designs. Cases with obligatory revisions as periprosthetic joint infections, stem loosening and periprosthetic fractures were excluded. Kaplan-Meier analysis was used to calculate humeral stem survival. Multivariate cox-regression analysis was used to determine risk factors for stem revision. RESULTS: The majority of procedures (respectively 90.9 and 72.1% for the convertible and non-convertible group) concerned a conversion to reverse shoulder arthroplasty (p = .02). In the convertible group, the stem was retained in 29 out of 40 patients (72.5%). Overall implant survival was 94.5% after a mean follow-up of 2.4 years. Hemiartroplasty, fracture as primary indication, previous shoulder surgery and lower age were risk factors for revision. CONCLUSIONS: Although convertible designs are gaining popularity due to their expected advantage in revision arthroplasty, surgeons should be aware that during a revision procedure in 27.5% of the patients an unforeseen stem revision is necessary. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-021-04247-z.
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spelling pubmed-80829072021-04-29 Stem retention and survival in revision of anatomical convertible shoulder arthroplasty to reverse arthroplasty: a Dutch registry study Theelen, Luuk M. A. Mory, Ben Venkatesan, Sharmila Spekenbrink-Spooren, Anneke Janssen, Loes Lambers Heerspink, Frederik O. BMC Musculoskelet Disord Research Article BACKGROUND: Convertible stem designs allow for stem retention during revision from anatomical to reverse shoulder arthroplasty. In some cases conversion is not possible for example due to excessive soft tissue tensioning. In these cases a total revision is necessary. The primary aim of this Dutch registry study was to evaluate the unforeseen stem reversion percentages in revision of convertible anatomical shoulder arthroplasty to reverse shoulder arthroplasty. METHODS: Shoulder arthroplasties (n = 2834) performed between 2014 and 2016 registered in the Dutch Arthroplasty Registry were selected. In 2016 94% of primary arthroplasties and 92% of revision arthroplasties were registered in the database. Arthroplasties were selected on convertibility. Mean follow-up was 2.4 years. We analysed the number of revisions for convertible and non-convertible designs. Cases with obligatory revisions as periprosthetic joint infections, stem loosening and periprosthetic fractures were excluded. Kaplan-Meier analysis was used to calculate humeral stem survival. Multivariate cox-regression analysis was used to determine risk factors for stem revision. RESULTS: The majority of procedures (respectively 90.9 and 72.1% for the convertible and non-convertible group) concerned a conversion to reverse shoulder arthroplasty (p = .02). In the convertible group, the stem was retained in 29 out of 40 patients (72.5%). Overall implant survival was 94.5% after a mean follow-up of 2.4 years. Hemiartroplasty, fracture as primary indication, previous shoulder surgery and lower age were risk factors for revision. CONCLUSIONS: Although convertible designs are gaining popularity due to their expected advantage in revision arthroplasty, surgeons should be aware that during a revision procedure in 27.5% of the patients an unforeseen stem revision is necessary. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-021-04247-z. BioMed Central 2021-04-28 /pmc/articles/PMC8082907/ /pubmed/33910540 http://dx.doi.org/10.1186/s12891-021-04247-z Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Theelen, Luuk M. A.
Mory, Ben
Venkatesan, Sharmila
Spekenbrink-Spooren, Anneke
Janssen, Loes
Lambers Heerspink, Frederik O.
Stem retention and survival in revision of anatomical convertible shoulder arthroplasty to reverse arthroplasty: a Dutch registry study
title Stem retention and survival in revision of anatomical convertible shoulder arthroplasty to reverse arthroplasty: a Dutch registry study
title_full Stem retention and survival in revision of anatomical convertible shoulder arthroplasty to reverse arthroplasty: a Dutch registry study
title_fullStr Stem retention and survival in revision of anatomical convertible shoulder arthroplasty to reverse arthroplasty: a Dutch registry study
title_full_unstemmed Stem retention and survival in revision of anatomical convertible shoulder arthroplasty to reverse arthroplasty: a Dutch registry study
title_short Stem retention and survival in revision of anatomical convertible shoulder arthroplasty to reverse arthroplasty: a Dutch registry study
title_sort stem retention and survival in revision of anatomical convertible shoulder arthroplasty to reverse arthroplasty: a dutch registry study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8082907/
https://www.ncbi.nlm.nih.gov/pubmed/33910540
http://dx.doi.org/10.1186/s12891-021-04247-z
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