Functional outcomes and complications of classic grammont-style reverse shoulder arthroplasty in patients with os acromiale: a retrospective case-control study.

IF 2.6 3区医学 Q2 ORTHOPEDICS

International Orthopaedics Pub Date : 2025-09-01 Epub Date: 2025-07-02 DOI:10.1007/s00264-025-06596-z

Yaiza Lopiz, Raul Herzog, Camilla Arvinius, Carlos Garcia, Esperanza Anhui, Fernando Marco

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引用次数: 0

Abstract

Purpose: To determine the functional impact and complications associated with os acromiale after the implantation of a reverse total shoulder arthroplasty (RTSA) with medialization of the centre of rotation.

Methods: A retrospective case-control study with cross-sectional evaluation was conducted. Between 2004 and 2021, patients who underwent RTSA for cuff arthropathy, GH osteoarthritis or massive irreparable rotator cuff tears with os acromiale (OA) and more thantwo years of follow-up, were identified. A control cohort (2:1) without acromial compromise (NOOA) was also identified. Functional (Constant, ASES, Quick-DASH, VAS, ROM) and radiological assessment (os acromiale type, acromiohumeral distance, acromion tilt) were performed.

Results: RTSA was implanted in 432 cases during the study period, 221 with rotator cuff arthropathy, irreparable tears, or osteoarthritis, of these, 12 had an os acromiale (OA) (5.4%) and were compared to 24 patients without os acromiale (NOOA). Epidemiologic data OA/NOOA were: female 10/20, mean follow-up 47.2 ± 25/56.1 ± 30 months, mean age 73.5 ± 4.7/75.4 ± 4.1 years. Regarding the difference in preoperative and final follow-up functional outcomes (OA/NOOA): Constant 20.2/30.9 (p =.012), ASES 28/54 (p =.017), Quick-DASH - 19.6/-27.2 (p =.220), VAS - 5/-7 (p =.007), difference in pre-surgery/last follow-up ROM: elevation 50º/60º (p =.138), abduction 60º/60º (p =.775). The os acromiale group presented two prosthetic dislocations (16.7%).

Conclusion: Patients with os acromiale improve their preoperative condition after RTSA implantation; however, although there are no differences in joint balance, this improvement is significantly lower in the Constant and ASES scores, primarily due to a decrease in strength and pain relief experienced by patients with os acromiale.

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肩峰缺失患者经典格拉蒙式反向肩关节置换术的功能结局和并发症：回顾性病例对照研究。

目的：探讨旋转中心内侧化逆行全肩关节置换术（RTSA）植入术后肩峰肌的功能影响及并发症。方法：采用回顾性病例-对照研究，进行横断面评价。在2004年至2021年期间，确定了因袖带关节病、GH骨关节炎或肩峰性关节炎（OA）的大量不可修复的肩袖撕裂而接受RTSA的患者，随访时间超过两年。一个没有肩峰损伤（NOOA）的对照队列（2:1）也被确定。进行功能评估（Constant、ASES、Quick-DASH、VAS、ROM）和放射学评估（肩峰类型、肩肱距离、肩峰倾斜）。结果:RTSA植入432例在研究期间,221年与肌腱套关节病,不可挽回的眼泪,或骨关节炎,其中12有一个os acromiale (OA)(5.4%)和24例相比没有os acromiale (NOOA)。流行病学资料OA/NOOA：女性10/20，平均随访47.2±25/56.1±30个月，平均年龄73.5±4.7/75.4±4.1岁。术前与终期随访功能结局的差异（OA/NOOA）： Constant 20.2/30.9 (p = 0.012), ASES 28/54 (p = 0.017)，速动dash - 19.6/-27.2 (p = 0.220), VAS - 5/-7 (p = 0.007)，术前/终期随访ROM差异：抬高50º/60º（p = 0.138），外展60º/60º（p = 0.775）。肩峰组出现2例假体脱位（16.7%）。结论：肩峰性骨质疏松患者行RTSA植入术后，术前状态明显改善；然而，尽管在关节平衡方面没有差异，但在Constant和ASES评分中，这种改善明显较低，主要是由于肩峰性骨质疏松患者的力量和疼痛缓解减少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Orthopaedics 医学-整形外科

CiteScore

5.50

自引率

7.40%

发文量

360

审稿时长

1 months

期刊介绍： International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.