In the JournalsPerspective

Promising 8-year results seen with reverse shoulder arthroplasty prosthesis

Recently published results showed a survival rate of 97.4% at 8 years with a specific reverse shoulder arthroplasty prosthesis.

“In case of primary reversed shoulder arthroplasty, long-term results show a high survival rate of more than 95%,” Alexander Van Tongel, MD, PhD, and Lieven De Wilde MD, PhD, told Healio.com/Orthopedics.

Researchers identified 126 primary Delta Xtend prostheses (DePuy Synthes) implanted between October 2006 and December 2009. There was a follow-up of at least 8 years available for 74 patients. The mean follow-up was 113.1 months. Shoulder function and pain were evaluated with age- and sex-adjusted Constant-Murley scores.

Results showed the mean age- and sex-adjusted Constant-Murley score was 44.6% preoperatively and was 75.8% at 3 months postoperatively and was 91.1% at 5 years. The mean age- and sex-adjusted Constant-Murley score at the latest follow-up visit was 79.9%. This was significantly lower compared with the age- and sex-adjusted Constant-Murley score at 5 years postoperatively. At the 8-year follow-up, the overall survival rate was 97.4%. by Monica Jaramillo

 

Recently published results showed a survival rate of 97.4% at 8 years with a specific reverse shoulder arthroplasty prosthesis.

“In case of primary reversed shoulder arthroplasty, long-term results show a high survival rate of more than 95%,” Alexander Van Tongel, MD, PhD, and Lieven De Wilde MD, PhD, told Healio.com/Orthopedics.

Researchers identified 126 primary Delta Xtend prostheses (DePuy Synthes) implanted between October 2006 and December 2009. There was a follow-up of at least 8 years available for 74 patients. The mean follow-up was 113.1 months. Shoulder function and pain were evaluated with age- and sex-adjusted Constant-Murley scores.

Results showed the mean age- and sex-adjusted Constant-Murley score was 44.6% preoperatively and was 75.8% at 3 months postoperatively and was 91.1% at 5 years. The mean age- and sex-adjusted Constant-Murley score at the latest follow-up visit was 79.9%. This was significantly lower compared with the age- and sex-adjusted Constant-Murley score at 5 years postoperatively. At the 8-year follow-up, the overall survival rate was 97.4%. by Monica Jaramillo

 

    Perspective
    Peter N. Chalmers

    Peter N. Chalmers

    The expanding utilization of reverse total shoulder arthroplasty (RTSA) has raised concerns about potential unknown long-term consequences. While several studies have provided long-term results for small groups of patients (<25 patients) to date, the only large series with long-term follow-up was from Dr. Walch’s group.

    Bassens and colleagues have published less than 8-year follow-up on 74 patients who underwent RTSA using the Delta Xtend implant, with a follow-up rate of 84% after the exclusion of deceased patients. The authors present no revisions or implant failures beyond the early post-operative period, with an impressive 97.4% implant retention rate. However, the authors do report a decline in constant scores between 5 years and final follow-up related to a loss of abduction strength and range of motion without a change in pain. This decline mirrors that previously published by Dr. Walch. While the source of this functional decline is unclear, this study confirms this decline and identifies long-term deltoid dysfunction as a target for improvement in the future of RTSA.

    References:

    Bacle G, et al. J Bone Joint Surg Am. 2017; doi:10.2106/JBJS.16.00223.
    Bassens D, et al. J Shoulder Elbow Surg. 2019;doi:10.1016/j.jse.2018.11.043.
    Chalmers PN, et al. Curr Rev Musculoskelet Medicine. 2016;doi:10.1007/s12178-016-9316-0.
    Chalmers PN, et al. J Am Acad Orthop Sur. 2018;doi:10.5435/JAAOS-D-17-00075.
    Ernstbrunner L, et al. J Bone Joint Surg Am. 2017;doi:10.2106/JBJS.17.00095.
    Gerber C, et al. J Shoulder Elbow Surg. 2018;doi:10.1016/j.jse.2017.10.037.


     

    • Peter N. Chalmers, MD
    • Division of shoulder and elbow surgery
      Department of orthopedic surgery
      University of Utah
      Salt Lake City

    Disclosures: Chalmers reports he is a paid consultant for Arthrex and Mitek.

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