Header

UZH-Logo

Maintenance Infos

Os Acromiale in Reverse Total Shoulder Arthroplasty: A Cohort Study


Carpeggiani, Guilherme; Hodel, Sandro; Götschi, Tobias; Kriechling, Philipp; Bösch, Marco; Meyer, Dominik C; Wieser, Karl (2020). Os Acromiale in Reverse Total Shoulder Arthroplasty: A Cohort Study. Orthopaedic Journal of Sports Medicine, 8(11):2325967120965131.

Abstract

Background

Increased passive deltoid tension after reverse total shoulder arthroplasty (RTSA) potentially leads to displacement or tilting of a preexisting os acromiale.

Purpose

To analyze patients with an os acromiale who underwent RTSA and compare their outcomes and complications with a matched control group without an os acromiale.

Study Design

Cohort study; Level of evidence, 3.

Methods

In this study, 45 shoulders in 42 patients with an os acromiale (cases) were matched to 133 patients without os acromiale (controls) who underwent RTSA between 2005 and 2016. The mean follow-up was 52 ± 32 months. Matching criteria included sex, type of surgery, duration of follow-up, and age. The Constant score (CS), Subjective Shoulder Value (SSV), and radiological outcomes were assessed postoperatively at 1-year, 2-year, and final follow-up visits.

Results

The mean CS, SSV, and range of motion improved from preoperative levels to the final follow-up in both groups (P < .01). Patients with an os acromiale had a relative CS of 70 ± 23 versus 76 ± 21 points (P = .15) and an SSV of 70 ± 30 versus 73 ± 24 (P = .52) compared with controls at the final follow-up visit. Patients with an os acromiale had significantly decreased active flexion of 104° ± 33° versus 114° ± 33° (P = .03) at 1 year and active abduction of 103° ± 37° versus 121° ± 38° at 2 years postoperatively (P = .02). A postoperatively painful os acromiale was found in 12 cases (27%) and spontaneously resolved in 8 cases after a mean of 33 months (range, 12-47 months; P = .04).

Conclusion

RTSA reliably restores patient satisfaction despite the presence of an os acromiale, with a slightly impaired range of motion. Postoperative local tenderness at the os acromiale can be expected in 1 out of 4 patients, but this resolves spontaneously over time in the majority of patients.

Abstract

Background

Increased passive deltoid tension after reverse total shoulder arthroplasty (RTSA) potentially leads to displacement or tilting of a preexisting os acromiale.

Purpose

To analyze patients with an os acromiale who underwent RTSA and compare their outcomes and complications with a matched control group without an os acromiale.

Study Design

Cohort study; Level of evidence, 3.

Methods

In this study, 45 shoulders in 42 patients with an os acromiale (cases) were matched to 133 patients without os acromiale (controls) who underwent RTSA between 2005 and 2016. The mean follow-up was 52 ± 32 months. Matching criteria included sex, type of surgery, duration of follow-up, and age. The Constant score (CS), Subjective Shoulder Value (SSV), and radiological outcomes were assessed postoperatively at 1-year, 2-year, and final follow-up visits.

Results

The mean CS, SSV, and range of motion improved from preoperative levels to the final follow-up in both groups (P < .01). Patients with an os acromiale had a relative CS of 70 ± 23 versus 76 ± 21 points (P = .15) and an SSV of 70 ± 30 versus 73 ± 24 (P = .52) compared with controls at the final follow-up visit. Patients with an os acromiale had significantly decreased active flexion of 104° ± 33° versus 114° ± 33° (P = .03) at 1 year and active abduction of 103° ± 37° versus 121° ± 38° at 2 years postoperatively (P = .02). A postoperatively painful os acromiale was found in 12 cases (27%) and spontaneously resolved in 8 cases after a mean of 33 months (range, 12-47 months; P = .04).

Conclusion

RTSA reliably restores patient satisfaction despite the presence of an os acromiale, with a slightly impaired range of motion. Postoperative local tenderness at the os acromiale can be expected in 1 out of 4 patients, but this resolves spontaneously over time in the majority of patients.

Statistics

Citations

Altmetrics

Downloads

1 download since deposited on 22 Feb 2021
1 download since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Orthopedics and Sports Medicine
Language:English
Date:24 November 2020
Deposited On:22 Feb 2021 16:05
Last Modified:01 Mar 2021 16:28
Publisher:Sage Publications
ISSN:2325-9671
OA Status:Gold
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1177/2325967120965131
PubMed ID:33294474

Download

Gold Open Access

Download PDF  'Os Acromiale in Reverse Total Shoulder Arthroplasty: A Cohort Study'.
Preview
Content: Published Version
Language: English
Filetype: PDF
Size: 382kB
View at publisher
Licence: Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)