Prevalence and risk factors of scapular stress fracture after reverse shoulder arthroplasty: a multicentric retrospective study
Purpose Scapular stress fracture (sSF) is a difficult complication to treat after reverse total shoulder arthroplasty (RSA). The aim of this study was to identify the prevalence and possible risk factors in a large population. Methods A total of 2165 RSAs that were implanted between January 2006 and...
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| Veröffentlicht in: | International orthopaedics 2021, Vol.45 (1), p.209-216 |
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| creator | Verstraete, O. Van der Mast, B. Van Tongel, A. Karelse, A. Van der Bracht, H. Berghs, B. Van Isacker, T. Verniers, P. De Wilde, L. |
| description | Purpose
Scapular stress fracture (sSF) is a difficult complication to treat after reverse total shoulder arthroplasty (RSA). The aim of this study was to identify the prevalence and possible risk factors in a large population.
Methods
A total of 2165 RSAs that were implanted between January 2006 and October 2017 in five hospitals were evaluated. Within this cohort, sSF was radiologically confirmed. Age, gender, surgical indication and hospital of treatment were determined for the entire cohort. A matched 3:1 case-control study was then performed to investigate several clinical and surgical variables.
Results
sSF occurred in 3.1% (63 patients), with a median time interval of five months post-operative [IQR = 9, range: (1–79)]. Within the entire cohort, females (OR = 2.99) and rotator cuff arthropathy (RCA) (OR = 2.79) were more prone to this complication. Age had little influence (OR = 1.03). After exclusion, fifty-five eligible cases were matched to 165 controls based on hospital, gender, age and surgical indication. After univariable analysis, significance was obtained for osteopenia (
P
= 0.037), osteoporosis (
P
= 0.032), surgical approach (
P
= 0.002) and peri-operative acromioclavicular (AC) joint surgery (
P
= 0.035). Multivariate analysis demonstrated that osteopenia (OR = 3.94), osteoporosis (OR = 2.85) and a deltopectoral approach (OR = 3.70) were independent risk factors.
Conclusion
According to our findings, older women with poor bone quality and a history of RCA suffered more frequently from sSF. Anterolateral approach during surgery was a surgical protective factor, possibly due to the mobilization of the acromioclavicular joint. Although this study indicates who is at risk for sSF, further investigation for prevention of sSF in these patients is necessary. |
| doi_str_mv | 10.1007/s00264-020-04849-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2460769701</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2460769701</sourcerecordid><originalsourceid>FETCH-LOGICAL-c347t-703533ebc5ea2e848a3eeb7e12f7f50cbafac0ec0e51ec5d6267e310c663978d3</originalsourceid><addsrcrecordid>eNp9kE1v1DAQhi0EotvCH-CAfOSSMrZjO-GGqvIhVYIDnC2vM6Ep2STM2JX2xF_HsIUjkiVLnud9NX6EeKHgUgH41wygXduAhgbaru0b_0jsVGt0Y1VvH4sdmFY12vX2TJwz3wEo7zr1VJwZozrrtd2Jn58J7-OMS0IZl0HSxN_lGFNeieU6Sk5xK3MkyZmQWY5UZ4UqPGYkWcNIjJJv1zIP9SFSvqV1myPn4xsZ5aHMeUq4ZJpSpTOtvGHK033N5DIcn4knY5wZnz_cF-Lru-svVx-am0_vP169vWmSaX1uPBhrDO6Txaixa7toEPcelR79aCHtY90ZsB6rMNnBaefRKEjOmd53g7kQr069G60_CnIOh4kTznNccC0cdOvAu96Dqqg-oakuy4Rj2Gg6RDoGBeG3-HASH6r48Ed88DX08qG_7A84_Iv8NV0BcwK4jpZvSOFuLbTUP_-v9hdD95J0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2460769701</pqid></control><display><type>article</type><title>Prevalence and risk factors of scapular stress fracture after reverse shoulder arthroplasty: a multicentric retrospective study</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Verstraete, O. ; Van der Mast, B. ; Van Tongel, A. ; Karelse, A. ; Van der Bracht, H. ; Berghs, B. ; Van Isacker, T. ; Verniers, P. ; De Wilde, L.</creator><creatorcontrib>Verstraete, O. ; Van der Mast, B. ; Van Tongel, A. ; Karelse, A. ; Van der Bracht, H. ; Berghs, B. ; Van Isacker, T. ; Verniers, P. ; De Wilde, L.</creatorcontrib><description>Purpose
Scapular stress fracture (sSF) is a difficult complication to treat after reverse total shoulder arthroplasty (RSA). The aim of this study was to identify the prevalence and possible risk factors in a large population.
Methods
A total of 2165 RSAs that were implanted between January 2006 and October 2017 in five hospitals were evaluated. Within this cohort, sSF was radiologically confirmed. Age, gender, surgical indication and hospital of treatment were determined for the entire cohort. A matched 3:1 case-control study was then performed to investigate several clinical and surgical variables.
Results
sSF occurred in 3.1% (63 patients), with a median time interval of five months post-operative [IQR = 9, range: (1–79)]. Within the entire cohort, females (OR = 2.99) and rotator cuff arthropathy (RCA) (OR = 2.79) were more prone to this complication. Age had little influence (OR = 1.03). After exclusion, fifty-five eligible cases were matched to 165 controls based on hospital, gender, age and surgical indication. After univariable analysis, significance was obtained for osteopenia (
P
= 0.037), osteoporosis (
P
= 0.032), surgical approach (
P
= 0.002) and peri-operative acromioclavicular (AC) joint surgery (
P
= 0.035). Multivariate analysis demonstrated that osteopenia (OR = 3.94), osteoporosis (OR = 2.85) and a deltopectoral approach (OR = 3.70) were independent risk factors.
Conclusion
According to our findings, older women with poor bone quality and a history of RCA suffered more frequently from sSF. Anterolateral approach during surgery was a surgical protective factor, possibly due to the mobilization of the acromioclavicular joint. Although this study indicates who is at risk for sSF, further investigation for prevention of sSF in these patients is necessary.</description><identifier>ISSN: 0341-2695</identifier><identifier>EISSN: 1432-5195</identifier><identifier>DOI: 10.1007/s00264-020-04849-7</identifier><identifier>PMID: 33185725</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Arthroplasty, Replacement, Shoulder - adverse effects ; Case-Control Studies ; Female ; Fractures, Stress ; Humans ; Medicine ; Medicine & Public Health ; Original Paper ; Orthopedics ; Prevalence ; Retrospective Studies ; Risk Factors ; Scapula - diagnostic imaging ; Scapula - surgery ; Shoulder Joint - diagnostic imaging ; Shoulder Joint - surgery ; Treatment Outcome</subject><ispartof>International orthopaedics, 2021, Vol.45 (1), p.209-216</ispartof><rights>SICOT aisbl 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-703533ebc5ea2e848a3eeb7e12f7f50cbafac0ec0e51ec5d6267e310c663978d3</citedby><cites>FETCH-LOGICAL-c347t-703533ebc5ea2e848a3eeb7e12f7f50cbafac0ec0e51ec5d6267e310c663978d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00264-020-04849-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00264-020-04849-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33185725$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Verstraete, O.</creatorcontrib><creatorcontrib>Van der Mast, B.</creatorcontrib><creatorcontrib>Van Tongel, A.</creatorcontrib><creatorcontrib>Karelse, A.</creatorcontrib><creatorcontrib>Van der Bracht, H.</creatorcontrib><creatorcontrib>Berghs, B.</creatorcontrib><creatorcontrib>Van Isacker, T.</creatorcontrib><creatorcontrib>Verniers, P.</creatorcontrib><creatorcontrib>De Wilde, L.</creatorcontrib><title>Prevalence and risk factors of scapular stress fracture after reverse shoulder arthroplasty: a multicentric retrospective study</title><title>International orthopaedics</title><addtitle>International Orthopaedics (SICOT)</addtitle><addtitle>Int Orthop</addtitle><description>Purpose
Scapular stress fracture (sSF) is a difficult complication to treat after reverse total shoulder arthroplasty (RSA). The aim of this study was to identify the prevalence and possible risk factors in a large population.
Methods
A total of 2165 RSAs that were implanted between January 2006 and October 2017 in five hospitals were evaluated. Within this cohort, sSF was radiologically confirmed. Age, gender, surgical indication and hospital of treatment were determined for the entire cohort. A matched 3:1 case-control study was then performed to investigate several clinical and surgical variables.
Results
sSF occurred in 3.1% (63 patients), with a median time interval of five months post-operative [IQR = 9, range: (1–79)]. Within the entire cohort, females (OR = 2.99) and rotator cuff arthropathy (RCA) (OR = 2.79) were more prone to this complication. Age had little influence (OR = 1.03). After exclusion, fifty-five eligible cases were matched to 165 controls based on hospital, gender, age and surgical indication. After univariable analysis, significance was obtained for osteopenia (
P
= 0.037), osteoporosis (
P
= 0.032), surgical approach (
P
= 0.002) and peri-operative acromioclavicular (AC) joint surgery (
P
= 0.035). Multivariate analysis demonstrated that osteopenia (OR = 3.94), osteoporosis (OR = 2.85) and a deltopectoral approach (OR = 3.70) were independent risk factors.
Conclusion
According to our findings, older women with poor bone quality and a history of RCA suffered more frequently from sSF. Anterolateral approach during surgery was a surgical protective factor, possibly due to the mobilization of the acromioclavicular joint. Although this study indicates who is at risk for sSF, further investigation for prevention of sSF in these patients is necessary.</description><subject>Aged</subject><subject>Arthroplasty, Replacement, Shoulder - adverse effects</subject><subject>Case-Control Studies</subject><subject>Female</subject><subject>Fractures, Stress</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Paper</subject><subject>Orthopedics</subject><subject>Prevalence</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Scapula - diagnostic imaging</subject><subject>Scapula - surgery</subject><subject>Shoulder Joint - diagnostic imaging</subject><subject>Shoulder Joint - surgery</subject><subject>Treatment Outcome</subject><issn>0341-2695</issn><issn>1432-5195</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1v1DAQhi0EotvCH-CAfOSSMrZjO-GGqvIhVYIDnC2vM6Ep2STM2JX2xF_HsIUjkiVLnud9NX6EeKHgUgH41wygXduAhgbaru0b_0jsVGt0Y1VvH4sdmFY12vX2TJwz3wEo7zr1VJwZozrrtd2Jn58J7-OMS0IZl0HSxN_lGFNeieU6Sk5xK3MkyZmQWY5UZ4UqPGYkWcNIjJJv1zIP9SFSvqV1myPn4xsZ5aHMeUq4ZJpSpTOtvGHK033N5DIcn4knY5wZnz_cF-Lru-svVx-am0_vP169vWmSaX1uPBhrDO6Txaixa7toEPcelR79aCHtY90ZsB6rMNnBaefRKEjOmd53g7kQr069G60_CnIOh4kTznNccC0cdOvAu96Dqqg-oakuy4Rj2Gg6RDoGBeG3-HASH6r48Ed88DX08qG_7A84_Iv8NV0BcwK4jpZvSOFuLbTUP_-v9hdD95J0</recordid><startdate>2021</startdate><enddate>2021</enddate><creator>Verstraete, O.</creator><creator>Van der Mast, B.</creator><creator>Van Tongel, A.</creator><creator>Karelse, A.</creator><creator>Van der Bracht, H.</creator><creator>Berghs, B.</creator><creator>Van Isacker, T.</creator><creator>Verniers, P.</creator><creator>De Wilde, L.</creator><general>Springer Berlin Heidelberg</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></search><sort><creationdate>2021</creationdate><title>Prevalence and risk factors of scapular stress fracture after reverse shoulder arthroplasty: a multicentric retrospective study</title><author>Verstraete, O. ; Van der Mast, B. ; Van Tongel, A. ; Karelse, A. ; Van der Bracht, H. ; Berghs, B. ; Van Isacker, T. ; Verniers, P. ; De Wilde, L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-703533ebc5ea2e848a3eeb7e12f7f50cbafac0ec0e51ec5d6267e310c663978d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Arthroplasty, Replacement, Shoulder - adverse effects</topic><topic>Case-Control Studies</topic><topic>Female</topic><topic>Fractures, Stress</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Paper</topic><topic>Orthopedics</topic><topic>Prevalence</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Scapula - diagnostic imaging</topic><topic>Scapula - surgery</topic><topic>Shoulder Joint - diagnostic imaging</topic><topic>Shoulder Joint - surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Verstraete, O.</creatorcontrib><creatorcontrib>Van der Mast, B.</creatorcontrib><creatorcontrib>Van Tongel, A.</creatorcontrib><creatorcontrib>Karelse, A.</creatorcontrib><creatorcontrib>Van der Bracht, H.</creatorcontrib><creatorcontrib>Berghs, B.</creatorcontrib><creatorcontrib>Van Isacker, T.</creatorcontrib><creatorcontrib>Verniers, P.</creatorcontrib><creatorcontrib>De Wilde, L.</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>International orthopaedics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Verstraete, O.</au><au>Van der Mast, B.</au><au>Van Tongel, A.</au><au>Karelse, A.</au><au>Van der Bracht, H.</au><au>Berghs, B.</au><au>Van Isacker, T.</au><au>Verniers, P.</au><au>De Wilde, L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence and risk factors of scapular stress fracture after reverse shoulder arthroplasty: a multicentric retrospective study</atitle><jtitle>International orthopaedics</jtitle><stitle>International Orthopaedics (SICOT)</stitle><addtitle>Int Orthop</addtitle><date>2021</date><risdate>2021</risdate><volume>45</volume><issue>1</issue><spage>209</spage><epage>216</epage><pages>209-216</pages><issn>0341-2695</issn><eissn>1432-5195</eissn><abstract>Purpose
Scapular stress fracture (sSF) is a difficult complication to treat after reverse total shoulder arthroplasty (RSA). The aim of this study was to identify the prevalence and possible risk factors in a large population.
Methods
A total of 2165 RSAs that were implanted between January 2006 and October 2017 in five hospitals were evaluated. Within this cohort, sSF was radiologically confirmed. Age, gender, surgical indication and hospital of treatment were determined for the entire cohort. A matched 3:1 case-control study was then performed to investigate several clinical and surgical variables.
Results
sSF occurred in 3.1% (63 patients), with a median time interval of five months post-operative [IQR = 9, range: (1–79)]. Within the entire cohort, females (OR = 2.99) and rotator cuff arthropathy (RCA) (OR = 2.79) were more prone to this complication. Age had little influence (OR = 1.03). After exclusion, fifty-five eligible cases were matched to 165 controls based on hospital, gender, age and surgical indication. After univariable analysis, significance was obtained for osteopenia (
P
= 0.037), osteoporosis (
P
= 0.032), surgical approach (
P
= 0.002) and peri-operative acromioclavicular (AC) joint surgery (
P
= 0.035). Multivariate analysis demonstrated that osteopenia (OR = 3.94), osteoporosis (OR = 2.85) and a deltopectoral approach (OR = 3.70) were independent risk factors.
Conclusion
According to our findings, older women with poor bone quality and a history of RCA suffered more frequently from sSF. Anterolateral approach during surgery was a surgical protective factor, possibly due to the mobilization of the acromioclavicular joint. Although this study indicates who is at risk for sSF, further investigation for prevention of sSF in these patients is necessary.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33185725</pmid><doi>10.1007/s00264-020-04849-7</doi><tpages>8</tpages></addata></record> |
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| ispartof | International orthopaedics, 2021, Vol.45 (1), p.209-216 |
| issn | 0341-2695 1432-5195 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | Aged Arthroplasty, Replacement, Shoulder - adverse effects Case-Control Studies Female Fractures, Stress Humans Medicine Medicine & Public Health Original Paper Orthopedics Prevalence Retrospective Studies Risk Factors Scapula - diagnostic imaging Scapula - surgery Shoulder Joint - diagnostic imaging Shoulder Joint - surgery Treatment Outcome |
| title | Prevalence and risk factors of scapular stress fracture after reverse shoulder arthroplasty: a multicentric retrospective study |
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