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The Influence of Sportive Activity on Radiographic Outcomes following Reverse Total Shoulder Arthroplasty: A Comparative Study

The Influence of Sportive Activity on Radiographic Outcomes following Reverse Total Shoulder Arthroplasty: A Comparative Study

Stephanie Geyer, MD, GERMANY Jakob Siebler, cand. med., GERMANY Felipe Eggers, MD, GERMANY Lukas Nawid Muench, MD, GERMANY Daniel P. Berthold, Association.-Prof., GERMANY Sebastian Siebenlist, MD, MHBA, Prof., GERMANY Andreas B. Imhoff, MD, Prof. Emeritus, GERMANY Bastian Scheiderer, MD, GERMANY

Department for Orthopaedic Sports Medicine, Technical University Munich, Munich, GERMANY


2021 Congress   Abstract Presentation   5 minutes   rating (1)

 

Anatomic Location

Anatomic Structure

Diagnosis / Condition

Treatment / Technique

Patient Populations

Diagnosis Method

Sports Medicine

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Summary: The present study was conducted to compare the clinical and radiographic outcomes of reverse total shoulder arthroplasty (RTSA) in a senior athletic and non-athletic population.


Purpose

The present study was conducted to compare the clinical and radiographic outcomes of reverse total shoulder arthroplasty (RTSA) in a senior athletic and non-athletic population. The hypothesis was that athletic high-demand patients demonstrate a higher rate of radiological changes around the implant such as radiolucency, loosening, and scapular notching when compared to non-athletic patients.

Methods

In this retrospective study, 71 consecutive patients who underwent RTSA with the Universe Reverse shoulder prosthesis were included. Minimum follow-up was 24 months. Patients who restarted sport following RTSA were assigned to the athletic group, while patients who discontinued sports were assigned to the non-athletic group. Outcome was evaluated with the Constant score (CS), the American Shoulder and Elbow Surgeons score (ASES), the Simple-Shoulder Test (SST), and a visual analog scale (VAS) for pain. Shoulder range of motion and abduction strength was assessed. Radiographic follow-up examination was based on a standardized core set of parameters for radiographic monitoring of patients following shoulder arthroplasty.

Results

61 patients (f:36; m:25; mean age 75.9 years) were available for follow-up survey (Follow-up: 47.1 months). 34 patients were assigned to the athletic group and 27 patients to the non-athletic group. The overall rate of return to sport was 78 %. The athletic group demonstrated superior clinical results and patient-rated-outcomes (PROs) with CS 68.6 (SD: 10.4), ASES 87.0 (SD: 10.4), SST 9.1 (SD: 2.0) and VAS 0.1 (SD: 0.3) compared to the non-athletic group (CS 55.2 (SD: 17.2), ASES 71.5 (SD: 21.3), SST 6.8 (SD: 2.9) and VAS 2.2 ( SD2.1)), respectively (P<.05). Incomplete radiolucency around the humeral component was found significantly more frequent in the athletic group compared to the non-athletic group (P=.019), whereas the occurrence of complete radiolucent lines around the implant components demonstrated no statistical difference between the two groups (P=.382). Incomplete radiolucency around the glenoid component was observed in 1 patient (3 %) of the athletic group, and 3 patients (11 %) of the non-athletic group (P=.2). There was no loosening and/or migration of the glenoid component. Scapular notching was observed in 18 patients (53 %) of the athletic group and 12 patients (44 %) of the non-athletic group (P=.51).

Conclusion

At mid-term follow-up, the athletic population demonstrated significantly better clinical results following RTSA without a higher rate of radiographic changes when compared to non-athletic patients. However, incomplete radiolucency around the humeral component was observed significantly more often in the athletic group, which may affect long-term implant survivorship.


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