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Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
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.7% and 0.6%, respectively. They found a decrease in revision rates after modification of the prosthesis design. Newer metal metaphyseal shell and polyethylene insert (0.2%) had a significantly lower rate of humeral component dissociation compared to the
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Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
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replacement: a modelling study . Clin Biomech (Bristol, Avon) 2009 ; 24 : 254 – 260 . 100. Boileau P Watkinson DJ Hatzidakis AM Balg F . Grammont reverse prosthesis: design, rationale, and biomechanics . J Shoulder Elbow Surg 2005
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
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Early reported complication rates with the Grammont-type reverse shoulder arthroplasty (RSA) were very high, up to 24%.
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A ‘problem’ is defined as an intraoperative or postoperative event that is not likely to affect the patient’s final outcome, such as intraoperative cement extravasation and radiographic changes. A ‘complication’ is defined as an intraoperative or postoperative event that is likely to affect the patient’s final outcome, including infection, neurologic injury and intrathoracic central glenoid screw placement.
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Radiographic changes around the glenoid or humeral components of the RSA are very frequently observed and described in the literature.
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High complication rates related to the Grammont RSA design led to development of non-Grammont designs which led to a dramatic fall in the majority of complications.
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The percentage of radiological changes after RSA is not negligible and remains unsolved, despite a decrease in its occurrence in the last decade. However, such changes should be now considered as simple problems because they rarely have a negative influence on the patient’s final outcome, and their prevalence has dramatically decreased.
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With further changes in indications and designs for RSA, it is crucial to accurately track the rates and types of complications to justify its new designs and increased indications.
Cite this article: EFORT Open Rev 2021;6:1109-1121. DOI: 10.1302/2058-5241.6.210040
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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-related research. Emerging trends Considerations for rTSA prosthesis design The development of rTSA prosthesis design has evolved from its early simplistic designs to the current more complex, individualized, and advanced stages. Currently, the implant
Upper Limb Unit, Department of Orthopedic Surgery, Amphia Hospital, Breda, The Netherlands
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Department of Orthopedic Surgery, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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Since the introduction of the radial head prosthesis (RHP) in 1941, many designs have been introduced. It is not clear whether prosthesis design parameters are related to early failure. The aim of this systematic review is to report on failure modes and to explore the association between implant design and early failure.
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A search was conducted to identify studies reporting on failed primary RHP. The results are clustered per type of RHP based on: material, fixation technique, modularity, and polarity. Chi-square tests are used to compare reasons for failure between the groups.
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Thirty-four articles are included involving 152 failed radial head arthroplasties (RHAs) in 152 patients. Eighteen different types of RHPs have been used.
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The most frequent reasons for revision surgery after RHA are (aseptic) loosening (30%), elbow stiffness (20%) and/or persisting pain (17%). Failure occurs after an average of 34 months (range, 0–348 months; median, 14 months).
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Press-fit prostheses fail at a higher ratio because of symptomatic loosening than intentionally loose-fit prostheses and prostheses that are fixed with an expandable stem (p < 0.01).
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Because of the many different types of RHP used to date and the limited numbers and evidence on early failure of RHA, the current data provide no evidence for a specific RHP design.
Cite this article: EFORT Open Rev 2019;4:659-667. DOI: 10.1302/2058-5241.4.180099
These authors contributed equally to this work
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Cell & Tissue Bank-Regenerative Medicine Centre, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
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graft or bone substitute, while the remaining studies did not provide adequate information. Table 2. ORIF and RTSA prosthesis characteristics No Author, publication year ORIF RTSA Prosthesis design Prosthesis
Royal Perth Hospital, Perth, Australia
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Royal Perth Hospital, Perth, Australia
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Grammont design (5.8% vs. 2.5%, p = 0.025). 59 This study, however, only looked at one lateralized prosthesis design. A more recent systematic review of 6583 RTSAs from 103 studies, found only a slight difference in aseptic loosening rates between
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replacement of the distal humerus with a prosthesis designed to re-create the articulation with the proximal ulna and radial head. There were several historical devices used for this purpose although only one is currently available, the Latitude EV
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: 492 - 499 . 82. 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 - 161S . 83
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Shoulder Elbow Surg 2012 ; 21 : 1470 - 1477 . PMID:22365818. 18. Boileau P , Watkinson DJ , Hatzidakis AM , Balg F . Grammont reverse prosthesis: design, rationale, and biomechanics . J Shoulder Elbow Surg
