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231226s2022 xx |||||o 00| ||eng c |
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|a 10.1016/j.jseint.2022.05.005
|2 doi
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|a pubmed24n1153.xml
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|a eng
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| 100 |
1 |
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|a Endell, David
|e verfasserin
|4 aut
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| 245 |
1 |
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|a Is it worth the risk? Clinical and radiographic outcomes 24 months after reverse shoulder arthroplasty in an advanced geriatric population
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|c 2022
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|a Text
|b txt
|2 rdacontent
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|a ƒaComputermedien
|b c
|2 rdamedia
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| 338 |
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|a ƒa Online-Ressource
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|2 rdacarrier
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|a Date Revised 12.09.2022
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|a published: Electronic-eCollection
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|a Citation Status PubMed-not-MEDLINE
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|a © 2022 The Author(s).
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|a Background: The application of reverse shoulder arthroplasty (RSA) has risen in the past decades especially due to its excellent long-term outcomes. With this positive trend, the indications for RSA have gradually extended to a broader age spectrum. The objective of this study was to identify the benefits of primary RSA in an advanced geriatric population with considerable comorbidity burden and higher perioperative risk
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|a Methods: For this observational study using data collected from our local RSA register, we identified 73 patients (77% female) with a minimum age of 85 years (range: 85-93 years) at the time of surgery and a complete 24-month postoperative follow-up. Clinical evaluations of pain, Subjective Shoulder Value, Constant score, Shoulder Pain and Disability Index, quality of life (European Quality-of-Life 5-Dimension 5-Level utility), and patient satisfaction were made. Radiographic evaluation followed an international consensus core set. Adverse events were documented according to a core event set
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|a Results: Preexisting medical conditions categorized following the American Society of Anesthesiologists physical status classification system indicated only 22% of patients with mild comorbidities (American Society of Anesthesiologists I-II), whereas severe (American Society of Anesthesiologists III-IV) comorbidities were common (78%). Indications for surgery were rotator cuff deficiency (72%), post-traumatic conditions (18%), and primary arthrosis (10%). There was significant improvement in all clinical evaluations up to 24 months post RSA: mean pain levels decreased from 6.2 to 1.6 points, where 0 indicates no pain (P < .001) and Subjective Shoulder Value, Constant score, Shoulder Pain and Disability Index, and European Quality of Life 5 Dimensions 5 Level increased from 36% to 76%, 26 to 61 points, 29 to 74 points, and 0.58 to 0.79, respectively (P < .001). Most patients (88%) opted in favor of undergoing the same surgery again based on their personal outcome. There were no signs of early loosening, migration or dislocation at 24 months postsurgery. However, 6 periprosthetic fractures were identified, 5 of which were treated conservatively. Adverse events were reported for 39% of patients, yet rarely led to the need for revision surgery (1.8%) or hospital readmission (3.6%)
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|a Conclusion: Despite an advanced age over 85 years and numerous associated comorbidities, our geriatric population showed a distinct clinical improvement in their daily activities with high rates of patient satisfaction. Radiographic analysis at 24 months after surgery identified adequate implant stability. RSA is a safe procedure, even in these elderly patients, with an acceptable risk of unfavorable medical and surgical events
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|a Journal Article
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| 650 |
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|a Complications
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| 650 |
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4 |
|a Elderly
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| 650 |
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4 |
|a Geriatric
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| 650 |
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|a Joint replacement
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| 650 |
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4 |
|a Outcome
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| 650 |
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|a Reverse shoulder arthroplasty
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| 650 |
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4 |
|a Shoulder surgery
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| 700 |
1 |
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|a Audigé, Laurent
|e verfasserin
|4 aut
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| 700 |
1 |
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|a Imiolczyk, Jan-Philipp
|e verfasserin
|4 aut
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| 700 |
1 |
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|a Scheibel, Markus
|e verfasserin
|4 aut
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| 700 |
1 |
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|a Freislederer, Florian
|e verfasserin
|4 aut
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