Reverse shoulder arthroplasty for complex fractures of the proximal humerus in elderly patients: impact on the level of independency, early function, and pain medication
Background This study investigated early functional outcome, quality of life, and the level of independency in elderly patients after primary reverse shoulder arthroplasty (RSA) for complex fractures of the proximal humerus. Methods This was a prospective case series that included 33 patients, aged...
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| Veröffentlicht in: | Journal of shoulder and elbow surgery 2017-08, Vol.26 (8), p.1462-1468 |
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| container_title | Journal of shoulder and elbow surgery |
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| creator | Wolfensperger, Fabian, MD Grüninger, Patrick, MD Dietrich, Michael, MD Völlink, Mathias, MD Benninger, Emanuel, MD Schläppi, Michel, MSc Meier, Christoph, MD |
| description | Background This study investigated early functional outcome, quality of life, and the level of independency in elderly patients after primary reverse shoulder arthroplasty (RSA) for complex fractures of the proximal humerus. Methods This was a prospective case series that included 33 patients, aged ≥70 years, with a high level of independency who received RSA for complex fractures of the humerus (Orthopaedic Trauma Association B2/C) from January 2012 to April 2014. Results Level of independency, quality of life (Short Form 36 Health Survey score), early functional outcome (Constant-Murley score, Disabilities of the Arm, Shoulder and Hand Outcome Measure), and pain medication (World Health Organization grading) were obtained at the 6-month follow-up and 1 year after surgery. The Constant-Murley score was 64 ± 14 after 6 months and 71 ± 12 at 1 year ( P |
| doi_str_mv | 10.1016/j.jse.2017.01.021 |
| format | Article |
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Methods This was a prospective case series that included 33 patients, aged ≥70 years, with a high level of independency who received RSA for complex fractures of the humerus (Orthopaedic Trauma Association B2/C) from January 2012 to April 2014. Results Level of independency, quality of life (Short Form 36 Health Survey score), early functional outcome (Constant-Murley score, Disabilities of the Arm, Shoulder and Hand Outcome Measure), and pain medication (World Health Organization grading) were obtained at the 6-month follow-up and 1 year after surgery. The Constant-Murley score was 64 ± 14 after 6 months and 71 ± 12 at 1 year ( P < .001), reaching 87% compared with the contralateral shoulder. The Disabilities of the Arm, Shoulder and Hand score reached 29 ± 20 at 6 months and 30 ± 21 at 1 year. The Short Form 36 score was comparable to normative data. After 6 months, 84% of our study group were back at their previous level of independency. Within 1 year, this rate increased to 91%. At the 1-year follow-up, analgesia intake was back at the level before the injury in 97% of the patients. Conclusions Primary RSA provides good early functional results, reliable pain control, and excellent restoration of an independent life style in elderly patients. Thus, RSA may be considered for active patients with a high demand on shoulder function.</description><identifier>ISSN: 1058-2746</identifier><identifier>EISSN: 1532-6500</identifier><identifier>DOI: 10.1016/j.jse.2017.01.021</identifier><identifier>PMID: 28372970</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Analgesics - therapeutic use ; Arthroplasty, Replacement, Shoulder - methods ; CMS ; DASH ; Female ; Follow-Up Studies ; Humans ; level of independence ; Life Style ; Male ; Orthopedics ; outcome ; Pain Management ; Prospective Studies ; proximal humeral fracture ; Quality of Life ; Reverse shoulder arthroplasty ; RSA ; Shoulder Fractures - surgery ; Shoulder Joint - physiopathology ; Shoulder Joint - surgery ; Shoulder Pain - drug therapy ; Treatment Outcome</subject><ispartof>Journal of shoulder and elbow surgery, 2017-08, Vol.26 (8), p.1462-1468</ispartof><rights>Journal of Shoulder and Elbow Surgery Board of Trustees</rights><rights>2017 Journal of Shoulder and Elbow Surgery Board of Trustees</rights><rights>Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-9ec291ab5ff2404b2895f95dc460463c5a335ae74fcdbeb93c998b872209537c3</citedby><cites>FETCH-LOGICAL-c408t-9ec291ab5ff2404b2895f95dc460463c5a335ae74fcdbeb93c998b872209537c3</cites><orcidid>0000-0002-3773-6164 ; 0000-0003-2512-3368</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1058274617300629$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28372970$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wolfensperger, Fabian, MD</creatorcontrib><creatorcontrib>Grüninger, Patrick, MD</creatorcontrib><creatorcontrib>Dietrich, Michael, MD</creatorcontrib><creatorcontrib>Völlink, Mathias, MD</creatorcontrib><creatorcontrib>Benninger, Emanuel, MD</creatorcontrib><creatorcontrib>Schläppi, Michel, MSc</creatorcontrib><creatorcontrib>Meier, Christoph, MD</creatorcontrib><title>Reverse shoulder arthroplasty for complex fractures of the proximal humerus in elderly patients: impact on the level of independency, early function, and pain medication</title><title>Journal of shoulder and elbow surgery</title><addtitle>J Shoulder Elbow Surg</addtitle><description>Background This study investigated early functional outcome, quality of life, and the level of independency in elderly patients after primary reverse shoulder arthroplasty (RSA) for complex fractures of the proximal humerus. Methods This was a prospective case series that included 33 patients, aged ≥70 years, with a high level of independency who received RSA for complex fractures of the humerus (Orthopaedic Trauma Association B2/C) from January 2012 to April 2014. Results Level of independency, quality of life (Short Form 36 Health Survey score), early functional outcome (Constant-Murley score, Disabilities of the Arm, Shoulder and Hand Outcome Measure), and pain medication (World Health Organization grading) were obtained at the 6-month follow-up and 1 year after surgery. The Constant-Murley score was 64 ± 14 after 6 months and 71 ± 12 at 1 year ( P < .001), reaching 87% compared with the contralateral shoulder. The Disabilities of the Arm, Shoulder and Hand score reached 29 ± 20 at 6 months and 30 ± 21 at 1 year. The Short Form 36 score was comparable to normative data. After 6 months, 84% of our study group were back at their previous level of independency. Within 1 year, this rate increased to 91%. At the 1-year follow-up, analgesia intake was back at the level before the injury in 97% of the patients. Conclusions Primary RSA provides good early functional results, reliable pain control, and excellent restoration of an independent life style in elderly patients. Thus, RSA may be considered for active patients with a high demand on shoulder function.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analgesics - therapeutic use</subject><subject>Arthroplasty, Replacement, Shoulder - methods</subject><subject>CMS</subject><subject>DASH</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>level of independence</subject><subject>Life Style</subject><subject>Male</subject><subject>Orthopedics</subject><subject>outcome</subject><subject>Pain Management</subject><subject>Prospective Studies</subject><subject>proximal humeral fracture</subject><subject>Quality of Life</subject><subject>Reverse shoulder arthroplasty</subject><subject>RSA</subject><subject>Shoulder Fractures - surgery</subject><subject>Shoulder Joint - physiopathology</subject><subject>Shoulder Joint - surgery</subject><subject>Shoulder Pain - drug therapy</subject><subject>Treatment Outcome</subject><issn>1058-2746</issn><issn>1532-6500</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kkuL1jAYhYsozjj6A9xIli6m9c2llygIMniDAcHLOqTpW758pklN2mH6k_yXpn6jCxdukhDOecJ7ToriKYWKAm1eHKtjwooBbSugFTB6rzinNWdlUwPcz2eou5K1ojkrHqV0BAApgD0szljHWyZbOC9-fsYbjAlJOoTVDRiJjsshhtnptGxkDJGYMM0Ob8kYtVnWiImEkSwHJHMMt3bSjhzWCeOaiPUEd4bbyKwXi35JL4md5uwjwf_2uPyc2wHWDzhjXrzZLgnq3TSu3iw2-Eui_ZARmTfhYI3eLx8XD0btEj652y-Kb-_efr36UF5_ev_x6s11aQR0SynRMEl1X48jEyB61sl6lPVgRAOi4abWnNcaWzGaocdeciNl13ctYyBr3hp-UTw_cfN4P1ZMi5psMuic9hjWpGjXCdqITjZZSk9SE0NKEUc1xxxI3BQFtTekjio3pPaGFFCVG8qeZ3f4tc_D_XX8qSQLXp0EmIe8sRhVMjlKk4OIaBY1BPtf_Ot_3MZZnyN033HDdAxr9Dk9RVViCtSX_YvsP4S2HKBhkv8CUWK6BQ</recordid><startdate>20170801</startdate><enddate>20170801</enddate><creator>Wolfensperger, Fabian, MD</creator><creator>Grüninger, Patrick, MD</creator><creator>Dietrich, Michael, MD</creator><creator>Völlink, Mathias, MD</creator><creator>Benninger, Emanuel, MD</creator><creator>Schläppi, Michel, MSc</creator><creator>Meier, Christoph, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3773-6164</orcidid><orcidid>https://orcid.org/0000-0003-2512-3368</orcidid></search><sort><creationdate>20170801</creationdate><title>Reverse shoulder arthroplasty for complex fractures of the proximal humerus in elderly patients: impact on the level of independency, early function, and pain medication</title><author>Wolfensperger, Fabian, MD ; Grüninger, Patrick, MD ; Dietrich, Michael, MD ; Völlink, Mathias, MD ; Benninger, Emanuel, MD ; Schläppi, Michel, MSc ; Meier, Christoph, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-9ec291ab5ff2404b2895f95dc460463c5a335ae74fcdbeb93c998b872209537c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analgesics - therapeutic use</topic><topic>Arthroplasty, Replacement, Shoulder - methods</topic><topic>CMS</topic><topic>DASH</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>level of independence</topic><topic>Life Style</topic><topic>Male</topic><topic>Orthopedics</topic><topic>outcome</topic><topic>Pain Management</topic><topic>Prospective Studies</topic><topic>proximal humeral fracture</topic><topic>Quality of Life</topic><topic>Reverse shoulder arthroplasty</topic><topic>RSA</topic><topic>Shoulder Fractures - surgery</topic><topic>Shoulder Joint - physiopathology</topic><topic>Shoulder Joint - surgery</topic><topic>Shoulder Pain - drug therapy</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wolfensperger, Fabian, MD</creatorcontrib><creatorcontrib>Grüninger, Patrick, MD</creatorcontrib><creatorcontrib>Dietrich, Michael, MD</creatorcontrib><creatorcontrib>Völlink, Mathias, MD</creatorcontrib><creatorcontrib>Benninger, Emanuel, MD</creatorcontrib><creatorcontrib>Schläppi, Michel, MSc</creatorcontrib><creatorcontrib>Meier, Christoph, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of shoulder and elbow surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wolfensperger, Fabian, MD</au><au>Grüninger, Patrick, MD</au><au>Dietrich, Michael, MD</au><au>Völlink, Mathias, MD</au><au>Benninger, Emanuel, MD</au><au>Schläppi, Michel, MSc</au><au>Meier, Christoph, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reverse shoulder arthroplasty for complex fractures of the proximal humerus in elderly patients: impact on the level of independency, early function, and pain medication</atitle><jtitle>Journal of shoulder and elbow surgery</jtitle><addtitle>J Shoulder Elbow Surg</addtitle><date>2017-08-01</date><risdate>2017</risdate><volume>26</volume><issue>8</issue><spage>1462</spage><epage>1468</epage><pages>1462-1468</pages><issn>1058-2746</issn><eissn>1532-6500</eissn><abstract>Background This study investigated early functional outcome, quality of life, and the level of independency in elderly patients after primary reverse shoulder arthroplasty (RSA) for complex fractures of the proximal humerus. Methods This was a prospective case series that included 33 patients, aged ≥70 years, with a high level of independency who received RSA for complex fractures of the humerus (Orthopaedic Trauma Association B2/C) from January 2012 to April 2014. Results Level of independency, quality of life (Short Form 36 Health Survey score), early functional outcome (Constant-Murley score, Disabilities of the Arm, Shoulder and Hand Outcome Measure), and pain medication (World Health Organization grading) were obtained at the 6-month follow-up and 1 year after surgery. The Constant-Murley score was 64 ± 14 after 6 months and 71 ± 12 at 1 year ( P < .001), reaching 87% compared with the contralateral shoulder. The Disabilities of the Arm, Shoulder and Hand score reached 29 ± 20 at 6 months and 30 ± 21 at 1 year. The Short Form 36 score was comparable to normative data. After 6 months, 84% of our study group were back at their previous level of independency. Within 1 year, this rate increased to 91%. At the 1-year follow-up, analgesia intake was back at the level before the injury in 97% of the patients. Conclusions Primary RSA provides good early functional results, reliable pain control, and excellent restoration of an independent life style in elderly patients. Thus, RSA may be considered for active patients with a high demand on shoulder function.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28372970</pmid><doi>10.1016/j.jse.2017.01.021</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-3773-6164</orcidid><orcidid>https://orcid.org/0000-0003-2512-3368</orcidid></addata></record> |
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| subjects | Aged Aged, 80 and over Analgesics - therapeutic use Arthroplasty, Replacement, Shoulder - methods CMS DASH Female Follow-Up Studies Humans level of independence Life Style Male Orthopedics outcome Pain Management Prospective Studies proximal humeral fracture Quality of Life Reverse shoulder arthroplasty RSA Shoulder Fractures - surgery Shoulder Joint - physiopathology Shoulder Joint - surgery Shoulder Pain - drug therapy Treatment Outcome |
| title | Reverse shoulder arthroplasty for complex fractures of the proximal humerus in elderly patients: impact on the level of independency, early function, and pain medication |
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