Journal article
Revision rate after screw or plate arthrodesis of the glenohumeral joint.
- Puskas GJ Orthopedic Department University, Balgrist University Hospital, Zurich, Switzerland. Electronic address: gabor_puskas@hotmail.com.
- Lädermann A Division of Orthopedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland; Division of Orthopedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland.
- Hirsiger S Orthopedic Department University, Balgrist University Hospital, Zurich, Switzerland.
- Hoffmeyer P Division of Orthopedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland.
- Gerber C Orthopedic Department University, Balgrist University Hospital, Zurich, Switzerland.
- 2017-07-04
Published in:
- Orthopaedics & traumatology, surgery & research : OTSR. - 2017
Arthrodesis
Screw and plate technique
Shoulder
Adolescent
Adult
Aged
Aged, 80 and over
Arthrodesis
Bone Plates
Bone Screws
Female
Follow-Up Studies
Humans
Male
Middle Aged
Outcome Assessment, Health Care
Reoperation
Retrospective Studies
Shoulder Joint
Young Adult
English
INTRODUCTION
Glenohumeral arthrodesis is a rare salvage procedure for selected patients with different shoulder pathologies. Among a variety of surgical techniques, compression screws or plate fixation are most widely used. Minimally invasive screw fixation has become more popular, although it has been shown to be biomechanically inferior to plate arthrodesis.
HYPOTHESIS
Screw arthrodesis would lead to a higher revision rate than plate arthrodesis.
MATERIAL AND METHODS
Twenty-seven plate and 7 screw arthrodesis of the glenohumeral joint in 19 male and 15 female patients of a mean age of 50years (range, 16-85years) were reviewed in a retrospective multicenter study with at a follow-up of 43months (range, 11-152months) to compare their clinical and radiographic outcome with special focus on revision rate.
RESULTS
Constant score did not change, but its subscore for pain significantly improved from 4.5 points (range, 0-15 points) to 11 points (range, 6-15 points). The subjective shoulder value increased significantly from 19% (range, 0-70%) to 41% (range, 10-80%) and 81% of the patients were satisfied. In 14 patients (41%), the arthrodesis had to be revised either for non-union (11) or malunion (3) at a mean of 12months (range, 0-47months). The 2 groups did not differ in terms of demographic data, nor of preoperative and postoperative clinical data. There were more revisions after screw than plate fixation. If revision was performed for non-union, this difference was significant.
DISCUSSION/CONCLUSION
In selected patients, glenohumeral arthrodesis can significantly reduce pain and achieve at best a reasonable function and subjective satisfaction rate. Revision rates favor plate over isolated screw fixation.
LEVEL OF EVIDENCE
IV retrospective series.
Glenohumeral arthrodesis is a rare salvage procedure for selected patients with different shoulder pathologies. Among a variety of surgical techniques, compression screws or plate fixation are most widely used. Minimally invasive screw fixation has become more popular, although it has been shown to be biomechanically inferior to plate arthrodesis.
HYPOTHESIS
Screw arthrodesis would lead to a higher revision rate than plate arthrodesis.
MATERIAL AND METHODS
Twenty-seven plate and 7 screw arthrodesis of the glenohumeral joint in 19 male and 15 female patients of a mean age of 50years (range, 16-85years) were reviewed in a retrospective multicenter study with at a follow-up of 43months (range, 11-152months) to compare their clinical and radiographic outcome with special focus on revision rate.
RESULTS
Constant score did not change, but its subscore for pain significantly improved from 4.5 points (range, 0-15 points) to 11 points (range, 6-15 points). The subjective shoulder value increased significantly from 19% (range, 0-70%) to 41% (range, 10-80%) and 81% of the patients were satisfied. In 14 patients (41%), the arthrodesis had to be revised either for non-union (11) or malunion (3) at a mean of 12months (range, 0-47months). The 2 groups did not differ in terms of demographic data, nor of preoperative and postoperative clinical data. There were more revisions after screw than plate fixation. If revision was performed for non-union, this difference was significant.
DISCUSSION/CONCLUSION
In selected patients, glenohumeral arthrodesis can significantly reduce pain and achieve at best a reasonable function and subjective satisfaction rate. Revision rates favor plate over isolated screw fixation.
LEVEL OF EVIDENCE
IV retrospective series.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1016/j.otsr.2017.05.021
- PMID 28669920
- Persistent URL
- https://sonar.ch/global/documents/11731
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