Resultados a corto plazo de la prótesis invertida de hombro según la patología. [Short-term results of shoulder reversal prosthesis according to pathology].
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Tabla 1 Prótesis Reversas
Tabla 2 Prótesis Reversas
Tabla 4 Prótesis Reversa
Tabla 5 Prótesis Reversa
Fig 2 A-E
Publicado:
nov 13, 2017
Palabras clave:
protesis reversa de hombro, resultados a corto plazo, complicaciones.Reverse shoulder prosthesis, short term results, complications.
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Resumen
ObjetivoAnalizar los resultados funcionales y las complicaciones a corto plazo de la prótesis reversa de hombro según diferentes patologías.Materiales y métodosEntre 2009 y 2013 se realizaron 85 prótesis reversas de hombro. Las indicaciones incluyeron: artropatía por ruptura del manguito rotador, artrosis glenohumeral, fracturas de húmero proximal y artroplastias de revisión. Se evaluaron los pacientes clínica y radiológicamente y se analizaron según los diferentes grupos.ResultadosEl seguimiento promedio fue de 42 meses (26-60) y la edad media 74.5 años (56-90). El Constant mejoró de 16.7 a 62.1 en promedio (P <.001) y el ASES, de 12.7 a 68.8 en promedio (P <.001). La elevación aumentó de 80.5 °a 111.5° (P <.001). No hubo mejoría significativa en la rotación interna ni externa. Sesenta pacientes (78,9 %) refirieron estar muy satisfechos/satisfechos. En 22 pacientes (27.8%) se hallaron muescas en el borde inferior de la glena. La tasa de complicaciones fue del 20%, siendo mas frecuentes en el grupo de fracturas y artroplastias de revisión.ConclusiónLa prótesis reversa de hombro mejora significativamente los scores funcionales, flexion anterior y abducción, independientemente de la indicación quirurgica. Presenta limitaciones con respecto a la rotacion externa e interna en el postoperatorio. Es una alternativa valida en multiples patologías de hombro, sin embargo presenta un elevado índice de complicaciones, por lo que su indicacion debe ser precisa, especialmente en pacientes a ser tratados por fracturas o en cirugias de revisión. Nivel de evidencia 4Abstract Objective: The purpose of this study is to analyze the short-term functional results and complications of the reverse shoulder prosthesis according to different etiologies.Methods: Between 2009 and 2013, 85 reverse shoulder arthroplasties were performed. Surgical indications included: rotator cuff tear artropathy, glenohumeral osteoarthritis, proximal humeral fractures and revision arthroplasty. Patients were clinically and radiologically evaluated and analyzed in different groups.Results: The mean follow-up was 42 months (range 26-60) and the mean age was 74.5 years (range 56-90). Constant score improved from 16.7 to 62.1 on average (p<.001) while ASES score improved from 12.7 to 68.8 on average (p<.001). Elevation increased from 80.5° to 111.5° (p<.001). There was no significant improvement in internal and external rotation. Sixty patients (78.9%) were very satisfied/satisfied. A total of 22 patients (27.8%) had notches in the inferior rim of the glenoid. Complication rate was 20%, being more frequent in the group of fractures and revision arthroplasties.Conclusions: The reverse shoulder arthroplasty significantly improved functional scores, anterior flexion and abduction, regardless of surgical indication. It has limitations with respect to the external and internal rotation postoperatively. It is a valid alternative in multiple shoulder conditions; however, complication rate is high, so the indication should be accurate, especially in patients treated for fractures or in revision surgeries.
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Bertona Altieri, B. A., Rossi, L., Oñativia, J. I., Tanoira, I., Bongiovanni, S., Maignon, G., & Ranalletta, M. (2017). Resultados a corto plazo de la prótesis invertida de hombro según la patología. [Short-term results of shoulder reversal prosthesis according to pathology]. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 82(4), 278-286. https://doi.org/10.15417/683
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Investigación Clínica
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Citas
1. Smith CD, Guyver P, Bunker TD. Indications for reverse shoulder replacement: a systematic review. J Bone Joint Surg Br. 2012 May;94(5):577-83.
2. Grammont PM, Trouilloud P, Laffay JP, Deries X. Etude et réalisation d’une nouvelle prothèse d’épaule. Rhumatologie. 1987;10:407-18.
3. Grammont PM, Baulot E. Delta shoulder prosthesis for rotator cuff rupture. Orthopedics. 1993;16:65-8.
4. Jobin CM, y col. Protesis reversa de hombre para el manejo de fracturas de humero proximal. Am Acad Orthop Surg 2015.
5. Gallinet D, Adam A, Gasse N, et al. Improvement in shoulder rotation in complex shoulder fractures treated by reverse shoulder arthroplasty. J Shoulder Elbow Surg 2013;22:38–44.
6. Katz D, Kilinc A, et al. Mid-term outcome of reverse shoulder prostheses in complex proximal humeral fractures. Acta Orthop Belg 2012;78:442–9.
7. Young AA, Smith MM, Bacle G, et al. Early results of reverse shoulder arthroplasty in patients with rheumatoid arthritis. J Bone Joint Surg Am 2011; 93:1915–23.
8. Ekelund A, Nyberg R. Can reverse shoulder arthroplasty be used with few complications in rheumatoid arthritis? Clin Orthop Relat Res 2011;469: 2483–8.
9. Hattrup SJ, Sanchez-Sotelo J, Sperling JW, et al. Reverse shoulder replacement for patients with inflammatory arthritis. J Hand Surg Am 2012;37: 1888–94.
10. Holcomb JO, Hebert DJ, Mighell MA, et al. Reverse shoulder arthroplasty in patients with rheumatoid arthritis. J Shoulder Elbow Surg 2010;19:1076–84.
11. Kelly JD 2nd, Zhao JX, Hobgood ER, et al. Clinical results of revision shoulder arthroplasty using the reverse prosthesis. J Shoulder Elbow Surg 2012; 21:1516–25.
12. Patel DN, Young B, Onyekwelu I, et al. Reverse total shoulder arthroplasty for failed shoulder arthroplasty. J Shoulder Elbow Surg 2012;21:1478–83.
13. Boileau P, Watkinson D, Hatzidakis AM, et al. Neer Award 2005: the Grammont reverse shoulder prosthesis: results in cuff tear arthritis, fracture sequelae, and revision arthroplasty. J Shoulder Elbow Surg 2006;15:527–40.
14. Hamada K, Fukuda H, Mikasa M, Kobayashi Y. Roentgenographic findings in massive rotator cuff tears. A long-term observation. Clin Orthop Relat Res. 1990;254:92-6.
15. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987;214:160-4.
16. Richards R, An KN, Bigliani L, et al: A standardized method of shoulder function. J Shoulder Elbow Surg 1994;3: 347-352.
17. Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Mole D. Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Joint Surg Br. 2004;86:388-95.
18. Boulahia A, Edwards TB, Walch G, Baratta RV. Early results of a reverse design prosthesis in the treatment of arthritis of the shoulder in elderly patients with a large rotator cuff tear. Orthopedics. 2002;25:129-33.
19. Frankle M, Siegal S, Pupello D, Saleem A, Mighell M, Vasey M. The Reverse Shoulder Prosthesis for glenohumeral arthritis associated with severe rotator cuff deficiency. A minimum two-year follow-up study of sixty patients. J Bone Joint Surg Am. 2005;87:1697-705.
20. Werner CM, Steinmann PA, Gilbart M, Gerber C. Treatment of painful pseudo-paresis due to irreparable rotator cuff dysfunction with the Delta III reverse-balland- socket total shoulder prosthesis. J Bone Joint Surg Am. 2005;87:1476-86.
21.Boileau P, Watkinson DJ, Hatzidakis AM, Balg F. Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elbow Surg. 2005;14(1 Suppl S):147S-61S.
22.Valenti PH, Boutens D, Nérot C. Delta 3 reversed prosthesis for osteoarthritis with massive rotator cuff tear: long term results. In: Walch G, Boileau P, Molé D, editors. 2000 Prothèses d'épaule recul de 2 à 10 ans. Paris: Sauramps Médical; 2001. p 253-9.
23. Guery J, Favard L, Sirveaux F, Oudet D, Mole D, Walch G. Reverse total der arthroplasty. Survivorship analysis of eighty replacements followed for five to ten years. J Bone Joint Surg Am. 2006;88:1742-7.
24. Favard L, Levigne C, Nerot C, et al. Reverse prostheses in arthropathies with cuff tear: are survivorship and function maintained over time? Clin Orthop Relat Res 2011;469:2469–2475.
25. Williams GR Jr, Rockwood CA Jr. Hemiarthroplasty in rotator cuff-deficient shoulders. J Shoulder Elbow Surg. 1996;5:362-7.
26. Sanchez-Sotelo J, Cofield RH, Rowland CM. Shoulder hemiarthroplasty for glenohumeral arthritis associated with severe rotator cuff deficiency. J Bone Joint Surg Am. 2001;83:1814-22.
27. Zuckerman JD, Scott AJ, Gallagher MA. Hemiarthroplasty for cuff tear arthropathy. J Shoulder Elbow Surg. 2000;9:169-72.
28. Sarris IK, Papadimitriou NG, Sotereanos DG. Bipolar hemiarthroplasty for chronic rotator cuff tear arthropathy. J Arthroplasty. 2003;18:169-73.
29. Wall B, Nov
2. Grammont PM, Trouilloud P, Laffay JP, Deries X. Etude et réalisation d’une nouvelle prothèse d’épaule. Rhumatologie. 1987;10:407-18.
3. Grammont PM, Baulot E. Delta shoulder prosthesis for rotator cuff rupture. Orthopedics. 1993;16:65-8.
4. Jobin CM, y col. Protesis reversa de hombre para el manejo de fracturas de humero proximal. Am Acad Orthop Surg 2015.
5. Gallinet D, Adam A, Gasse N, et al. Improvement in shoulder rotation in complex shoulder fractures treated by reverse shoulder arthroplasty. J Shoulder Elbow Surg 2013;22:38–44.
6. Katz D, Kilinc A, et al. Mid-term outcome of reverse shoulder prostheses in complex proximal humeral fractures. Acta Orthop Belg 2012;78:442–9.
7. Young AA, Smith MM, Bacle G, et al. Early results of reverse shoulder arthroplasty in patients with rheumatoid arthritis. J Bone Joint Surg Am 2011; 93:1915–23.
8. Ekelund A, Nyberg R. Can reverse shoulder arthroplasty be used with few complications in rheumatoid arthritis? Clin Orthop Relat Res 2011;469: 2483–8.
9. Hattrup SJ, Sanchez-Sotelo J, Sperling JW, et al. Reverse shoulder replacement for patients with inflammatory arthritis. J Hand Surg Am 2012;37: 1888–94.
10. Holcomb JO, Hebert DJ, Mighell MA, et al. Reverse shoulder arthroplasty in patients with rheumatoid arthritis. J Shoulder Elbow Surg 2010;19:1076–84.
11. Kelly JD 2nd, Zhao JX, Hobgood ER, et al. Clinical results of revision shoulder arthroplasty using the reverse prosthesis. J Shoulder Elbow Surg 2012; 21:1516–25.
12. Patel DN, Young B, Onyekwelu I, et al. Reverse total shoulder arthroplasty for failed shoulder arthroplasty. J Shoulder Elbow Surg 2012;21:1478–83.
13. Boileau P, Watkinson D, Hatzidakis AM, et al. Neer Award 2005: the Grammont reverse shoulder prosthesis: results in cuff tear arthritis, fracture sequelae, and revision arthroplasty. J Shoulder Elbow Surg 2006;15:527–40.
14. Hamada K, Fukuda H, Mikasa M, Kobayashi Y. Roentgenographic findings in massive rotator cuff tears. A long-term observation. Clin Orthop Relat Res. 1990;254:92-6.
15. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987;214:160-4.
16. Richards R, An KN, Bigliani L, et al: A standardized method of shoulder function. J Shoulder Elbow Surg 1994;3: 347-352.
17. Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Mole D. Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Joint Surg Br. 2004;86:388-95.
18. Boulahia A, Edwards TB, Walch G, Baratta RV. Early results of a reverse design prosthesis in the treatment of arthritis of the shoulder in elderly patients with a large rotator cuff tear. Orthopedics. 2002;25:129-33.
19. Frankle M, Siegal S, Pupello D, Saleem A, Mighell M, Vasey M. The Reverse Shoulder Prosthesis for glenohumeral arthritis associated with severe rotator cuff deficiency. A minimum two-year follow-up study of sixty patients. J Bone Joint Surg Am. 2005;87:1697-705.
20. Werner CM, Steinmann PA, Gilbart M, Gerber C. Treatment of painful pseudo-paresis due to irreparable rotator cuff dysfunction with the Delta III reverse-balland- socket total shoulder prosthesis. J Bone Joint Surg Am. 2005;87:1476-86.
21.Boileau P, Watkinson DJ, Hatzidakis AM, Balg F. Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elbow Surg. 2005;14(1 Suppl S):147S-61S.
22.Valenti PH, Boutens D, Nérot C. Delta 3 reversed prosthesis for osteoarthritis with massive rotator cuff tear: long term results. In: Walch G, Boileau P, Molé D, editors. 2000 Prothèses d'épaule recul de 2 à 10 ans. Paris: Sauramps Médical; 2001. p 253-9.
23. Guery J, Favard L, Sirveaux F, Oudet D, Mole D, Walch G. Reverse total der arthroplasty. Survivorship analysis of eighty replacements followed for five to ten years. J Bone Joint Surg Am. 2006;88:1742-7.
24. Favard L, Levigne C, Nerot C, et al. Reverse prostheses in arthropathies with cuff tear: are survivorship and function maintained over time? Clin Orthop Relat Res 2011;469:2469–2475.
25. Williams GR Jr, Rockwood CA Jr. Hemiarthroplasty in rotator cuff-deficient shoulders. J Shoulder Elbow Surg. 1996;5:362-7.
26. Sanchez-Sotelo J, Cofield RH, Rowland CM. Shoulder hemiarthroplasty for glenohumeral arthritis associated with severe rotator cuff deficiency. J Bone Joint Surg Am. 2001;83:1814-22.
27. Zuckerman JD, Scott AJ, Gallagher MA. Hemiarthroplasty for cuff tear arthropathy. J Shoulder Elbow Surg. 2000;9:169-72.
28. Sarris IK, Papadimitriou NG, Sotereanos DG. Bipolar hemiarthroplasty for chronic rotator cuff tear arthropathy. J Arthroplasty. 2003;18:169-73.
29. Wall B, Nov