Walch, J Shoulder Elbow Surg 2009 - Acromial Insufficiency in Reverse Shoulder Arthroplasties - Article Summary

Acromial Insufficiency in Reverse Shoulder Arthroplasties

Walch, Favard, et al.·J Shoulder Elbow Surg·2009·187 citations·Retrospective cohort

Purpose

Hypothesis: Reverse shoulder prostheses depend on deltoid function. An injury to the acromion, either fracture or meso-acromion, or deltoid injury, may affect the outcomes of patients after receiving a reverse shoulder prosthesis.

Methods

4-hundred and 57 consecutive reverse shoulder prostheses were implanted between January 1992 and June 2003 by one of 7 surgeons in 5 separate centers.
41 patients were noted to have a pre-operative lesion of the acromion or scapular spine.
23 presented with an os acromiale (meso-acromion).
17 had fracture or fragmentation of the acromion.
One patient had a pseudarthrosis of the scapular spine.

Results

Preoperative acromial pathology, surgical approach, and amount of inferior acromial tilt did not diminished postoperative range of motion, Constant score, or subjective results when compared to patients without acromial pathology.
In contrast, the four patients with postoperative acromial spine fractures had inferior results with respect to functional and subjective results.

Conclusions

Preoperative acromial lesions are not a contraindication to reverse shoulder arthroplasty. Postoperative fracture of the acromial spine has a significant effect on results and treatment is uncertain.

Supplemental

Acromial Insufficiency in Reverse Shoulder Arthroplasties.

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Acromial Insufficiency in Reverse Shoulder Arthroplasties

Walch, Favard, et al.·J Shoulder Elbow Surg·2009·187 citations·Retrospective cohort

DOI·PubMed

Purpose

Methods

4-hundred and 57 consecutive reverse shoulder prostheses were implanted between January 1992 and June 2003 by one of 7 surgeons in 5 separate centers.
41 patients were noted to have a pre-operative lesion of the acromion or scapular spine.
23 presented with an os acromiale (meso-acromion).
17 had fracture or fragmentation of the acromion.
One patient had a pseudarthrosis of the scapular spine.

Results

Preoperative acromial pathology, surgical approach, and amount of inferior acromial tilt did not diminished postoperative range of motion, Constant score, or subjective results when compared to patients without acromial pathology.
In contrast, the four patients with postoperative acromial spine fractures had inferior results with respect to functional and subjective results.

Conclusions

Preoperative acromial lesions are not a contraindication to reverse shoulder arthroplasty. Postoperative fracture of the acromial spine has a significant effect on results and treatment is uncertain.

Purpose

Methods

4-hundred and 57 consecutive reverse shoulder prostheses were implanted between January 1992 and June 2003 by one of 7 surgeons in 5 separate centers.
41 patients were noted to have a pre-operative lesion of the acromion or scapular spine.
23 presented with an os acromiale (meso-acromion).
17 had fracture or fragmentation of the acromion.
One patient had a pseudarthrosis of the scapular spine.

Results

Preoperative acromial pathology, surgical approach, and amount of inferior acromial tilt did not diminished postoperative range of motion, Constant score, or subjective results when compared to patients without acromial pathology.
In contrast, the four patients with postoperative acromial spine fractures had inferior results with respect to functional and subjective results.

Conclusions

Preoperative acromial lesions are not a contraindication to reverse shoulder arthroplasty. Postoperative fracture of the acromial spine has a significant effect on results and treatment is uncertain.

Purpose

Methods

4-hundred and 57 consecutive reverse shoulder prostheses were implanted between January 1992 and June 2003 by one of 7 surgeons in 5 separate centers.
41 patients were noted to have a pre-operative lesion of the acromion or scapular spine.
23 presented with an os acromiale (meso-acromion).
17 had fracture or fragmentation of the acromion.
One patient had a pseudarthrosis of the scapular spine.

Results

Preoperative acromial pathology, surgical approach, and amount of inferior acromial tilt did not diminished postoperative range of motion, Constant score, or subjective results when compared to patients without acromial pathology.
In contrast, the four patients with postoperative acromial spine fractures had inferior results with respect to functional and subjective results.

Conclusions

Preoperative acromial lesions are not a contraindication to reverse shoulder arthroplasty. Postoperative fracture of the acromial spine has a significant effect on results and treatment is uncertain.