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Reversed shoulder arthroplasty leads to significant histological changes of the deltoid muscle: a prospective intervention trial

INTRODUCTION: Reverse shoulder arthroplasty (RSA) shows promising short- and mid-term results in cuff tear arthropathy. However, functional impairments are described in long-term findings. Micromorphological changes in the periarticular musculature could be in part responsible for this, but have not...

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Autores principales: Koch, Matthias, Schmidt, Christian, Kerschbaum, Maximilian, Winkler, Tobias, Pfeifer, Christian G., Greiner, Stefan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8215043/
https://www.ncbi.nlm.nih.gov/pubmed/32529387
http://dx.doi.org/10.1007/s00402-020-03503-6
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author Koch, Matthias
Schmidt, Christian
Kerschbaum, Maximilian
Winkler, Tobias
Pfeifer, Christian G.
Greiner, Stefan
author_facet Koch, Matthias
Schmidt, Christian
Kerschbaum, Maximilian
Winkler, Tobias
Pfeifer, Christian G.
Greiner, Stefan
author_sort Koch, Matthias
collection PubMed
description INTRODUCTION: Reverse shoulder arthroplasty (RSA) shows promising short- and mid-term results in cuff tear arthropathy. However, functional impairments are described in long-term findings. Micromorphological changes in the periarticular musculature could be in part responsible for this, but have not yet been analysed. Thus, histological changes of the deltoid muscle and their association to the functional outcome were evaluated in this study. MATERIAL AND METHODS: A total of 15 patients treated with RSA were included in this prospective study. Functional outcome was assessed using the Constant Score (CS) and the DASH (disabilities of the arm, shoulder and hand) Score before RSA and after a mean follow-up of 12 months. Deltoid muscle biopsies were harvested intraoperatively and 12 months postoperatively. Mean deltoid muscle fibre area (MMFA) was calculated histologically after haematoxylin–eosin staining. RESULTS: Postoperative shoulder function significantly improved within 12 months (CS: Δ 37.4 ± 22.6, p = 0.001; DASH: Δ 27.1 ± 29.1, p = 0.006). The MMFA significantly decreased (p = 0.02), comparing the results from the intraoperative biopsy (MMFA: 8435.8 µm(2), SD ± 5995.9 µm(2)) to the 12 months biopsy (MMFA: 5792. µm(2), SD ± 3223.6 µm(2)). No correlation could be found between the functional score results and MMFA. CONCLUSION: Signs of deltoid muscle changes in terms of a reduced MMFA can be detected 1 year after RSA and thus already a long time before long-term functional impairments become apparent. Further studies with larger patient series and longer follow-up periods as well as extended histological assessments and simultaneous radiological examinations are required.
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spelling pubmed-82150432021-07-01 Reversed shoulder arthroplasty leads to significant histological changes of the deltoid muscle: a prospective intervention trial Koch, Matthias Schmidt, Christian Kerschbaum, Maximilian Winkler, Tobias Pfeifer, Christian G. Greiner, Stefan Arch Orthop Trauma Surg Orthopaedic Surgery INTRODUCTION: Reverse shoulder arthroplasty (RSA) shows promising short- and mid-term results in cuff tear arthropathy. However, functional impairments are described in long-term findings. Micromorphological changes in the periarticular musculature could be in part responsible for this, but have not yet been analysed. Thus, histological changes of the deltoid muscle and their association to the functional outcome were evaluated in this study. MATERIAL AND METHODS: A total of 15 patients treated with RSA were included in this prospective study. Functional outcome was assessed using the Constant Score (CS) and the DASH (disabilities of the arm, shoulder and hand) Score before RSA and after a mean follow-up of 12 months. Deltoid muscle biopsies were harvested intraoperatively and 12 months postoperatively. Mean deltoid muscle fibre area (MMFA) was calculated histologically after haematoxylin–eosin staining. RESULTS: Postoperative shoulder function significantly improved within 12 months (CS: Δ 37.4 ± 22.6, p = 0.001; DASH: Δ 27.1 ± 29.1, p = 0.006). The MMFA significantly decreased (p = 0.02), comparing the results from the intraoperative biopsy (MMFA: 8435.8 µm(2), SD ± 5995.9 µm(2)) to the 12 months biopsy (MMFA: 5792. µm(2), SD ± 3223.6 µm(2)). No correlation could be found between the functional score results and MMFA. CONCLUSION: Signs of deltoid muscle changes in terms of a reduced MMFA can be detected 1 year after RSA and thus already a long time before long-term functional impairments become apparent. Further studies with larger patient series and longer follow-up periods as well as extended histological assessments and simultaneous radiological examinations are required. Springer Berlin Heidelberg 2020-06-11 2021 /pmc/articles/PMC8215043/ /pubmed/32529387 http://dx.doi.org/10.1007/s00402-020-03503-6 Text en © The Author(s) 2020 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/) .
spellingShingle Orthopaedic Surgery
Koch, Matthias
Schmidt, Christian
Kerschbaum, Maximilian
Winkler, Tobias
Pfeifer, Christian G.
Greiner, Stefan
Reversed shoulder arthroplasty leads to significant histological changes of the deltoid muscle: a prospective intervention trial
title Reversed shoulder arthroplasty leads to significant histological changes of the deltoid muscle: a prospective intervention trial
title_full Reversed shoulder arthroplasty leads to significant histological changes of the deltoid muscle: a prospective intervention trial
title_fullStr Reversed shoulder arthroplasty leads to significant histological changes of the deltoid muscle: a prospective intervention trial
title_full_unstemmed Reversed shoulder arthroplasty leads to significant histological changes of the deltoid muscle: a prospective intervention trial
title_short Reversed shoulder arthroplasty leads to significant histological changes of the deltoid muscle: a prospective intervention trial
title_sort reversed shoulder arthroplasty leads to significant histological changes of the deltoid muscle: a prospective intervention trial
topic Orthopaedic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8215043/
https://www.ncbi.nlm.nih.gov/pubmed/32529387
http://dx.doi.org/10.1007/s00402-020-03503-6
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