Abstract:
INTRODUCTION:The aim of this study is to analyze the long-term results and possible complications of the Grammont reverse shoulder prosthesis in the management of recent trauma in the elderly patient. PATIENTS AND METHODS:Two male and 33 female patients of mean age 75 years (range, 58 to 92), operated on for 24 fractures and eleven facture-dislocations, involving the right side in 11 cases and the left side in 24 cases, were included in a retrospective study and were clinically and radiographically evaluated at a mean follow-up ranging from 1 to 17 years. RESULTS:Eight complications occurred in eight patients (23%): two complex regional pain syndromes, four dislocations, one deep infection and one aseptic loosening of the metaglene. Six patients (17%) had to be reoperated on, without prosthetic replacement in four cases and with revision of their shoulder implant in two. The mean Constant score decreased from 55 to 53 between one postoperative year and last follow-up since patients complained of increased pain and strength loss. This score was 69% of that of the contralateral shoulder. The adjusted Constant score was 68%. Only 58% of the patients were "satisfied" or "very satisfied" with the treatment due to limited shoulder rotations thus preventing proper eating, dressing and body hygiene habits when injury involved the dominant side. Two cases of complete lucent lines surrounding the glenoid component were observed at four and eight postoperative years respectively, a stable inferior bony spur was noted in 14 cases at a mean follow-up of 2.5 years with no functional effects, 20 cases of scapular notching having occurred within two-year follow-up were identified, 10 of which associated with bone resorption and medial proximal humeral lucent lines at the bone-cement interface. The extent of scapular notching progressed with the length of follow-up. Forty-nine percent of the radiographic images were considered abnormal and appeared within seven-year follow-up in 60% of the cases. Clinical and radiographic data comparison revealed a decrease in the Constant score regarding pain, activity, strength and active elevation when scapular notching was associated with abnormal humeral radiographic images. DISCUSSION:Despite one single case of aseptic loosening of the metaglene at 12-year follow-up, the results of our series are clinically disappointing and radiographically worrying associated with a substantial rate of complications and reopperations. The long-term functional outcome is far from being identical to the pre-trauma clinical status with a potential evolution toward loss of autonomy when the dominant side is affected. New prosthetic design characteristics and surgical technique improvements should be implemented to improve shoulder adduction but also rotations while preventing the occurrence of scapular notching. In the light of these results, we cannot validate the concept of primary reverse shoulder arthroplasty in the management of recent trauma of the proximal humerus.
journal_name
Orthop Traumatol Surg Resjournal_title
Orthopaedics & traumatology, surgery & research : OTSRauthors
Cazeneuve JF,Cristofari DJdoi
10.1016/j.otsr.2011.03.025subject
Has Abstractpub_date
2011-10-01 00:00:00pages
583-9issue
6issn
1877-0568pii
S1877-0568(11)00161-7journal_volume
97pub_type
杂志文章abstract::Emergency arthroplasty of the metacarpophalangeal joint (MCPJ) remains a valuable treatment option in patients with MCPJ destruction but may raise challenges in the event of substantial metacarpal and/or phalangeal bone defects. We report three cases of MCPJ destruction with bone defects at the proximal first phalanx ...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2017.07.007
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Meniscal replacement by an allograft or scaffold has been proven effective in patients with post-meniscectomy pain syndrome. Replacement of both menisci is a rarely performed procedure about which little is known. The primary objective of this work was to assess the functional outcomes of arthroscopic bimeni...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2019.08.010
更新日期:2019-11-01 00:00:00
abstract:INTRODUCTION:Shoulder arthroscopy is particularly suited to outpatient surgery, thanks to advances in anesthetic and analgesic techniques. The main goal of this study was to compare postoperative recovery after shoulder arthroscopy between outpatient and inpatient management. HYPOTHESIS:There is no difference in funct...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2017.10.010
更新日期:2018-02-01 00:00:00
abstract::Information is everywhere in the surgeon's life. It can improve medical practice and allow for personalized care. To answer the question, "How should the surgeon be connected?" we must assess the role and limitations of digital information in daily practice, particularly through mobile applications or mHealth. These t...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2018.05.018
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Endoscopic piriformis release (EPR) is among the available treatments for piriformis syndrome. This procedure typically involves dividing the muscle near the sciatic nerve in the sub-gluteal space, which contains numerous blood vessels and nerves. The objectives of this prospective cadaver study were: 1) to ...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2018.02.018
更新日期:2018-12-01 00:00:00
abstract:INTRODUCTION:Despite recent treatment advances, management of distal humerus fractures in the elderly remains one of the most challenging aspects of trauma surgery. Although these fractures are relatively rare, they fall under the umbrella of osteoporotic fractures, which themselves are increasing in frequency. MATERI...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,多中心研究
doi:10.1016/j.otsr.2013.08.002
更新日期:2013-11-01 00:00:00
abstract::Although total hip arthroplasty is now a classic procedure that is well controlled by orthopedic surgeons, some cases remain complex. Difficulties may be due to co-morbidities: obesity, skin problems, muscular problems, a history of neurological disease or associated morphological bone deformities. Obese patients must...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2012.11.008
更新日期:2013-02-01 00:00:00
abstract::The French tarification à l'activité (T2A) prospective payment system is a financial system in which a health-care institution's resources are based on performed activity. Activity is described via the PMSI medical information system (programme de médicalisation du système d'information). The PMSI classifies hospital ...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2013.06.009
更新日期:2014-02-01 00:00:00
abstract:INTRODUCTION:The main complication of reverse shoulder arthroplasty is the development of notches in the scapular pillar, which occurs in 44% to 100% of cases. Furthermore the functional score has been shown to be poorer in patients with high-grade notches. Many options have been proposed to reduce this risk. The purpo...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2014.06.013
更新日期:2014-11-01 00:00:00
abstract:INTRODUCTION:Implant fixation assessment following Vancouver B1 periprosthetic hip fracture is a major decision factor for internal fixation and/or implant revision. The main aim of the present study was to assess the correlation between radiographic Remaining Attachment Index (RAI) and risk of implant loosening at las...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.06.016
更新日期:2020-11-01 00:00:00
abstract:INTRODUCTION:Internal fixation is the preferred treatment of Garden I femoral neck fractures in the elderly. High re-operation rates have however been reported, and the results of arthroplasty performed following internal fixation failure are not as good as those of primary arthroplasty. This is why we are advocating f...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2009.11.012
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:Anterior cervical fusion is widely used to treat spinal injuries. Radiological evidence of disc abnormalities may develop on either side of the fused segment, raising concern about the potential for inducing adjacent-segment disease. Here, we report the long-term clinical, functional, and radiological outcom...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2014.02.003
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Latarjet is one of the most common surgical procedure performed on patients with shoulder instability with osseous defects, some complications include coracoid bone graft osteolysis, osteoarthritis, graft detachment, and malpositioning were previously reported. Several studies investigated potential causes o...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2019.11.007
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Abundant anatomic descriptions exist of the posterior cruciate ligament (PCL) and menisco-femoral ligaments (MFLs). There is broad agreement that the PCL is composed of two bundles and inserts on the femur near the distal cartilage. However, a different configuration with a single bundle and a complex femora...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.102788
更新日期:2020-12-14 00:00:00
abstract:INTRODUCTION:In case of failure of non-operative treatment of isolated supraspinatus tear, tendon surgery can improve shoulder function and alleviate pain. The present study hypothesis was that isolated supraspinatus repair shows good healing, with improved clinical results. MATERIALS AND METHODS:A prospective multice...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.08.007
更新日期:2020-12-01 00:00:00
abstract:INTRODUCTION:Osteoarthritis (OA) of the shoulder in under-50 year-olds is rare, and treatment is delicate. Shoulder replacement incurs frequent long-term risk of progression and a high revision rate, making it unsuited to young active patients. The aim of the present study was to determine the epidemiology of shoulder ...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.102756
更新日期:2020-12-11 00:00:00
abstract:INTRODUCTION:Intrathecal morphine (ITM) is a well-known and extensively used method for analgesia in various surgical fields; however, its relevance in spine surgery is debated given the conflicting results in the literature. The aim of this study was to investigate the opioid-sparing effect of ITM after lumbar fusion....
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.02.024
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Postoperative dislocation is the commonest complication following revision total hip arthroplasty (THA). HYPOTHESIS AND TYPE OF STUDY: Dual mobility cups are supposed to reduce the risk of THA instability. The present retrospective study tested this hypothesis on revision THAs and also, assessed this design ...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2009.04.016
更新日期:2009-10-01 00:00:00
abstract::When dealing with severe bone loss during acetabular revision of a total hip arthroplasty, it can be difficult to find a reliable anatomical structure to ensure high-quality primary fixation of the cup. Since 2003, we have been using an implant with a long peg that is anchored into the iliac isthmus. This structure is...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2012.01.006
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:The removal of well-fixed acetabular components following THA (total hip arthroplasty) is a difficult operation and could be accompanied by the loss of acetabular bone stock. The optimal method for fixation is still under debate. The aim of this pilot study was to compare the tear-out resistance and failure ...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2016.06.007
更新日期:2016-10-01 00:00:00
abstract:INTRODUCTION:Management of septic non-union of the tibia requires debridement and excision of all infected bone and soft tissues. Various surgical techniques have been described to fill the bone defect. The "Induced Membrane" technique, described by A. C. Masquelet in 1986, is a two-step procedure using a PMMA cement s...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2018.04.013
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Anterior shoulder dislocation causes injury to the inferior gleno-humeral ligament (IGHL) and capsule. Clinical manoeuvres currently used to evaluate the IGHL test for, and may induce, apprehension. We developed the hyper extension-internal rotation (HERI) test to assess the IGHL and inferior capsule without...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2015.10.006
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:It has been biomechanically demonstrated that 20% to 25% is a critical glenoid bone loss. Recently, there are several reports describing that a bone loss less than 20% to 25% needed to be treated because patients may have decreased quality of life without recurrent instability events. The purpose of this stu...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2019.08.015
更新日期:2019-12-01 00:00:00
abstract::With the development of conservative hip surgery techniques, new entities such as microinstability have been identified. Microinstability is a painful supra-physiological mobility of the hip. It results from the association of architectural and functional abnormalities impairing joint stability. These risk factors con...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2016.09.002
更新日期:2016-12-01 00:00:00
abstract::The diagnosis of pathological fracture should be considered routinely in patients with long limb-bone fractures. Investigations must be performed to establish the diagnosis of pathological fracture then to determine that the bone lesion is a metastasis. In over 85% of cases, the clinical evaluation combined with a det...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2016.11.001
更新日期:2017-02-01 00:00:00
abstract:UNLABELLED:In emerging countries, nonunion in the shaft of fractured long bones is common. PATIENTS AND METHODS:In a 3-year long prospective study, 50 patients (38 men, 12 women) with an average age of 40.9 years (range 17-60) were treated for neglected diaphyseal nonunion an average of 11 months (range 6-48) after th...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2014.07.005
更新日期:2014-10-01 00:00:00
abstract::Proximal femoral fracture in elderly subjects is a major event that is life-threatening in the medium-to-long term. Advanced age, male gender and number of comorbidities largely account for high mortality and require geriatric expertise. Protein-energy malnutrition and bone demineralization increase mortality. Mortali...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2017.04.020
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Imaging studies done to evaluate chronic ankle instability (CAI) often fail to accurately detail injuries to the anterior talo-fibular ligament (ATFL) and may, therefore, also fail to provide guidance for selecting the most appropriate surgical procedure. Arthroscopy is now an indispensable tool for accurate...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,多中心研究
doi:10.1016/j.otsr.2018.09.008
更新日期:2018-12-01 00:00:00
abstract:INTRODUCTION:Treatment of the distal radius fracture in elderly remains controversial. The objective was to assess the outcomes of volar locking plate for displaced complete intra-articular distal radius fractures in elderly as compared to younger patients. HYPOTHESIS:The outcomes in elderly patients would be comparab...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2019.12.008
更新日期:2020-04-01 00:00:00
abstract::Medical and surgical treatment of osteogenesis imperfecta has undergone two revolutions that improved quality of life and functional capacity: reduced bone absorption with the use of bisphosphonates, and improvement in internal fixation with the development of Dubow-Bailey then Fassier-Duval™ telescopic rodding. Teles...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2020.102759
更新日期:2020-12-11 00:00:00