Reversed total shoulder arthroplasty after acromioclavicular joint resection yields equivalent clinical results compared to a matched control group
Introduction Reverse total shoulder arthroplasty (RTSA) is a well-establish procedure with increasing incidence. Depending on the medical history, many patients undergo multiple soft-tissue procedures before RTSA. The role of acromioclavicular pathology as well as the consequences of a distal clavic...
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| Veröffentlicht in: | European journal of orthopaedic surgery & traumatology 2023-12, Vol.33 (8), p.3547-3553 |
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| creator | Cirigliano, Gabriele Kriechling, Philipp Wieser, Karl Camenzind, Roland Stefan |
| description | Introduction
Reverse total shoulder arthroplasty (RTSA) is a well-establish procedure with increasing incidence. Depending on the medical history, many patients undergo multiple soft-tissue procedures before RTSA. The role of acromioclavicular pathology as well as the consequences of a distal clavicle resection (DCR) before RTSA has not been evaluated yet.
Material and methods
A retrospective single-center review was performed on all patients undergoing primary RTSA with or without DCR with a minimum follow-up of 2 years. We compared patient-reported outcome measures (Constant score (CS), subjective shoulder values (SSV), and range of motion (ROM)) with a matched control group. The control group consisted of patients treated with a RTSA without DCR and matching was performed for age, sex, operating side, American Society of Anesthesiologists (ASA), body mass index (BMI), and indication. Surgical time and complication rate were recorded.
Results
Thirty-nine patients with a mean follow-up of 63 months (SD 33) were enrolled in the study group. Mean age was 67 years (SD 7) with 44% male patients for both groups. The mean relative CS improved from 43% (SD 17) to 73% (SD 20) in the study group, and from 43% (18) to 73% (22) in the control group. The SSV improved from 29% (SD 17) to 63% (SD 29) in the study group, and from 28% (SD 16) to 69% (SD 26) in the control group (both n.s.). The postoperative ROM did not significantly differ between the two groups. Five patients in the study group and six in the control group had reoperations.
Conclusion
Patients who received a DCR before RTSA showed equivalent clinical outcomes compared to a match-control group with RTSA only. Surgical time was not different, and no complication related to the open DCR was observed in the study group. Therefore, we conclude that a prior DCR does not influence the postoperative outcome after RTSA.
Level of evidence
Level III: Retrospective comparative study. |
| doi_str_mv | 10.1007/s00590-023-03576-0 |
| format | Article |
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Reverse total shoulder arthroplasty (RTSA) is a well-establish procedure with increasing incidence. Depending on the medical history, many patients undergo multiple soft-tissue procedures before RTSA. The role of acromioclavicular pathology as well as the consequences of a distal clavicle resection (DCR) before RTSA has not been evaluated yet.
Material and methods
A retrospective single-center review was performed on all patients undergoing primary RTSA with or without DCR with a minimum follow-up of 2 years. We compared patient-reported outcome measures (Constant score (CS), subjective shoulder values (SSV), and range of motion (ROM)) with a matched control group. The control group consisted of patients treated with a RTSA without DCR and matching was performed for age, sex, operating side, American Society of Anesthesiologists (ASA), body mass index (BMI), and indication. Surgical time and complication rate were recorded.
Results
Thirty-nine patients with a mean follow-up of 63 months (SD 33) were enrolled in the study group. Mean age was 67 years (SD 7) with 44% male patients for both groups. The mean relative CS improved from 43% (SD 17) to 73% (SD 20) in the study group, and from 43% (18) to 73% (22) in the control group. The SSV improved from 29% (SD 17) to 63% (SD 29) in the study group, and from 28% (SD 16) to 69% (SD 26) in the control group (both n.s.). The postoperative ROM did not significantly differ between the two groups. Five patients in the study group and six in the control group had reoperations.
Conclusion
Patients who received a DCR before RTSA showed equivalent clinical outcomes compared to a match-control group with RTSA only. Surgical time was not different, and no complication related to the open DCR was observed in the study group. Therefore, we conclude that a prior DCR does not influence the postoperative outcome after RTSA.
Level of evidence
Level III: Retrospective comparative study.</description><identifier>ISSN: 1432-1068</identifier><identifier>ISSN: 1633-8065</identifier><identifier>EISSN: 1432-1068</identifier><identifier>DOI: 10.1007/s00590-023-03576-0</identifier><identifier>PMID: 37222850</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Acromioclavicular Joint - surgery ; Aged ; Arthroplasty, Replacement, Shoulder - adverse effects ; Arthroplasty, Replacement, Shoulder - methods ; Control Groups ; Female ; Humans ; Joint replacement surgery ; Male ; Medicine ; Medicine & Public Health ; Original Article ; Range of Motion, Articular ; Retrospective Studies ; Shoulder ; Shoulder Joint - surgery ; Surgical Orthopedics ; Traumatic Surgery ; Treatment Outcome</subject><ispartof>European journal of orthopaedic surgery & traumatology, 2023-12, Vol.33 (8), p.3547-3553</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-b73bd75ef278d98318df05f0e7f67f32cd2bc49763d00242b7a65a4942a6961c3</citedby><cites>FETCH-LOGICAL-c375t-b73bd75ef278d98318df05f0e7f67f32cd2bc49763d00242b7a65a4942a6961c3</cites><orcidid>0000-0002-9096-2910</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00590-023-03576-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00590-023-03576-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37222850$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cirigliano, Gabriele</creatorcontrib><creatorcontrib>Kriechling, Philipp</creatorcontrib><creatorcontrib>Wieser, Karl</creatorcontrib><creatorcontrib>Camenzind, Roland Stefan</creatorcontrib><title>Reversed total shoulder arthroplasty after acromioclavicular joint resection yields equivalent clinical results compared to a matched control group</title><title>European journal of orthopaedic surgery & traumatology</title><addtitle>Eur J Orthop Surg Traumatol</addtitle><addtitle>Eur J Orthop Surg Traumatol</addtitle><description>Introduction
Reverse total shoulder arthroplasty (RTSA) is a well-establish procedure with increasing incidence. Depending on the medical history, many patients undergo multiple soft-tissue procedures before RTSA. The role of acromioclavicular pathology as well as the consequences of a distal clavicle resection (DCR) before RTSA has not been evaluated yet.
Material and methods
A retrospective single-center review was performed on all patients undergoing primary RTSA with or without DCR with a minimum follow-up of 2 years. We compared patient-reported outcome measures (Constant score (CS), subjective shoulder values (SSV), and range of motion (ROM)) with a matched control group. The control group consisted of patients treated with a RTSA without DCR and matching was performed for age, sex, operating side, American Society of Anesthesiologists (ASA), body mass index (BMI), and indication. Surgical time and complication rate were recorded.
Results
Thirty-nine patients with a mean follow-up of 63 months (SD 33) were enrolled in the study group. Mean age was 67 years (SD 7) with 44% male patients for both groups. The mean relative CS improved from 43% (SD 17) to 73% (SD 20) in the study group, and from 43% (18) to 73% (22) in the control group. The SSV improved from 29% (SD 17) to 63% (SD 29) in the study group, and from 28% (SD 16) to 69% (SD 26) in the control group (both n.s.). The postoperative ROM did not significantly differ between the two groups. Five patients in the study group and six in the control group had reoperations.
Conclusion
Patients who received a DCR before RTSA showed equivalent clinical outcomes compared to a match-control group with RTSA only. Surgical time was not different, and no complication related to the open DCR was observed in the study group. Therefore, we conclude that a prior DCR does not influence the postoperative outcome after RTSA.
Level of evidence
Level III: Retrospective comparative study.</description><subject>Acromioclavicular Joint - surgery</subject><subject>Aged</subject><subject>Arthroplasty, Replacement, Shoulder - adverse effects</subject><subject>Arthroplasty, Replacement, Shoulder - methods</subject><subject>Control Groups</subject><subject>Female</subject><subject>Humans</subject><subject>Joint replacement surgery</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Range of Motion, Articular</subject><subject>Retrospective Studies</subject><subject>Shoulder</subject><subject>Shoulder Joint - surgery</subject><subject>Surgical Orthopedics</subject><subject>Traumatic Surgery</subject><subject>Treatment Outcome</subject><issn>1432-1068</issn><issn>1633-8065</issn><issn>1432-1068</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kctq3DAUhkVpaZJpX6CLIuimG7dHkmVZyxLSCwQCIVkbWZIzGmTL0WVgniMvXCWTXuiiG93Od_4j_h-hdwQ-EQDxOQFwCQ1Q1gDjomvgBTolLaMNga5_-df5BJ2ltAMgXBL-Gp0wQSntOZyih2u7tzFZg3PIyuO0DcUbG7GKeRvD6lXKB6ym_PikY5hd0F7tnS5eRbwLbsk42mR1dmHBB2e9SdjeF7dX3taa9m5xugpXqPicsA7zquLTPKzwrLLe1osOS47B47sYyvoGvZqUT_bt875Bt18vbs6_N5dX336cf7lsNBM8N6NgoxHcTlT0RvaM9GYCPoEVUycmRrWho26l6JgBoC0dheq4amVLVSc7otkGfTzqrjHcF5vyMLukrfdqsaGkgfakF201tqvoh3_QXShxqb-rlKy-9pLKStEjVY1KKdppWKObVTwMBIbHyIZjZEONbHiKrK4b9P5ZuoyzNb9bfmVUAXYEUi0tdzb-mf0f2Z-tZaTs</recordid><startdate>20231201</startdate><enddate>20231201</enddate><creator>Cirigliano, Gabriele</creator><creator>Kriechling, Philipp</creator><creator>Wieser, Karl</creator><creator>Camenzind, Roland Stefan</creator><general>Springer Paris</general><general>Springer Nature B.V</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>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9096-2910</orcidid></search><sort><creationdate>20231201</creationdate><title>Reversed total shoulder arthroplasty after acromioclavicular joint resection yields equivalent clinical results compared to a matched control group</title><author>Cirigliano, Gabriele ; Kriechling, Philipp ; Wieser, Karl ; Camenzind, Roland Stefan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-b73bd75ef278d98318df05f0e7f67f32cd2bc49763d00242b7a65a4942a6961c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Acromioclavicular Joint - surgery</topic><topic>Aged</topic><topic>Arthroplasty, Replacement, Shoulder - adverse effects</topic><topic>Arthroplasty, Replacement, Shoulder - methods</topic><topic>Control Groups</topic><topic>Female</topic><topic>Humans</topic><topic>Joint replacement surgery</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Range of Motion, Articular</topic><topic>Retrospective Studies</topic><topic>Shoulder</topic><topic>Shoulder Joint - surgery</topic><topic>Surgical Orthopedics</topic><topic>Traumatic Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cirigliano, Gabriele</creatorcontrib><creatorcontrib>Kriechling, Philipp</creatorcontrib><creatorcontrib>Wieser, Karl</creatorcontrib><creatorcontrib>Camenzind, Roland Stefan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of orthopaedic surgery & traumatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cirigliano, Gabriele</au><au>Kriechling, Philipp</au><au>Wieser, Karl</au><au>Camenzind, Roland Stefan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reversed total shoulder arthroplasty after acromioclavicular joint resection yields equivalent clinical results compared to a matched control group</atitle><jtitle>European journal of orthopaedic surgery & traumatology</jtitle><stitle>Eur J Orthop Surg Traumatol</stitle><addtitle>Eur J Orthop Surg Traumatol</addtitle><date>2023-12-01</date><risdate>2023</risdate><volume>33</volume><issue>8</issue><spage>3547</spage><epage>3553</epage><pages>3547-3553</pages><issn>1432-1068</issn><issn>1633-8065</issn><eissn>1432-1068</eissn><abstract>Introduction
Reverse total shoulder arthroplasty (RTSA) is a well-establish procedure with increasing incidence. Depending on the medical history, many patients undergo multiple soft-tissue procedures before RTSA. The role of acromioclavicular pathology as well as the consequences of a distal clavicle resection (DCR) before RTSA has not been evaluated yet.
Material and methods
A retrospective single-center review was performed on all patients undergoing primary RTSA with or without DCR with a minimum follow-up of 2 years. We compared patient-reported outcome measures (Constant score (CS), subjective shoulder values (SSV), and range of motion (ROM)) with a matched control group. The control group consisted of patients treated with a RTSA without DCR and matching was performed for age, sex, operating side, American Society of Anesthesiologists (ASA), body mass index (BMI), and indication. Surgical time and complication rate were recorded.
Results
Thirty-nine patients with a mean follow-up of 63 months (SD 33) were enrolled in the study group. Mean age was 67 years (SD 7) with 44% male patients for both groups. The mean relative CS improved from 43% (SD 17) to 73% (SD 20) in the study group, and from 43% (18) to 73% (22) in the control group. The SSV improved from 29% (SD 17) to 63% (SD 29) in the study group, and from 28% (SD 16) to 69% (SD 26) in the control group (both n.s.). The postoperative ROM did not significantly differ between the two groups. Five patients in the study group and six in the control group had reoperations.
Conclusion
Patients who received a DCR before RTSA showed equivalent clinical outcomes compared to a match-control group with RTSA only. Surgical time was not different, and no complication related to the open DCR was observed in the study group. Therefore, we conclude that a prior DCR does not influence the postoperative outcome after RTSA.
Level of evidence
Level III: Retrospective comparative study.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>37222850</pmid><doi>10.1007/s00590-023-03576-0</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-9096-2910</orcidid></addata></record> |
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| subjects | Acromioclavicular Joint - surgery Aged Arthroplasty, Replacement, Shoulder - adverse effects Arthroplasty, Replacement, Shoulder - methods Control Groups Female Humans Joint replacement surgery Male Medicine Medicine & Public Health Original Article Range of Motion, Articular Retrospective Studies Shoulder Shoulder Joint - surgery Surgical Orthopedics Traumatic Surgery Treatment Outcome |
| title | Reversed total shoulder arthroplasty after acromioclavicular joint resection yields equivalent clinical results compared to a matched control group |
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