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Glenohumeral Instability and Clinical Outcomes Following Proximal Humerus Resection and Megaprosthesis Implantation: A Systematic Review.

Background: Glenohumeral instability is one of the most frequent and clinically impactful complications following proximal humerus resection and reconstruction with a megaprosthesis, especially in patients treated for bone tumors or complex fractures. Its incidence, risk factors, and influence on functional recovery remain variably reported in the literature. Methods: A systematic review was conducted according to PRISMA guidelines, searching PubMed, Scopus, and Google Scholar up to April 2025. Studies reporting on postoperative instability, dislocation, functional outcomes (MSTS, DASH), and r

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… prosthesis[All Fields] OR joint replacement[All Fields] OR Joint Prosthesis[MeSH]) AND (shoulder instability[All Fields] OR glenohumeral instability[All Fields] OR shoulder dislocation[All Fields] OR instability[All Fields] OR Shoulder Dislocation[MeSH] OR Joint Instability[MeSH]) AND (rate[All Fields … Early functional and therapeutic effect of reversed tumour shoulder prosthesis reconstruction after proximal humerus tumour resection. Front. Surg. 2022;9:987161. doi: 10.3389/fsurg.2022.987161. 22. Black A.W., Szabo R.M., Titelman R.M. …

The Role of Amputation and Myoelectric Prosthetic Fitting in Patients with Traumatic Brachial Plexus Injuries.

BACKGROUND: A cohort of patients with traumatic brachial plexus injuries (BPIs) underwent elective amputation following unsuccessful surgical reconstruction or delayed presentation. The results of amputation with and without a myoelectric prosthesis (MEP) using nonintuitive controls were compared. We sought to determine the benefits of amputation, and whether fitting with an MEP was feasible and functional. METHODS: We conducted a retrospective review of patients with BPI who underwent elective upper-extremity amputation at a single institution. Medical records were reviewed for demographics,

Long term results after bipolar radial head arthroplasty.

Radial head fractures are common injuries, occurring mostly in active young people 85%. Treatment of the more complex radial head fractures (Mason type III and IV), appear to be challenging and remain a subject of controversy. Replacement of the radial head with a metal prosthesis imitates the stabilizing role of the radial head and has been considered as the treatment of choice. However, long-term results are scarce. We report our mid to long-term (mean 9.4 year) clinical and radiographic results after insertion of a Judet Bipolar Radial Head prosthesis. 34 patients were treated with the Jude

The reverse shoulder arthroplasty angle may contribute to overt inferior inclination: comparison with alternative parameters.

PURPOSE: Radiographic measurements have gained wide acceptance in anticipating the risk of inappropriate glenoid component positioning in reverse shoulder arthroplasty (RSA). This study aims to investigate whether the RSA angle overcorrects the base plate inclination, tilting it inferiorly, compared to the base plate correction angle (BCA), which provides neutral inclination and lateralization. METHODS: One hundred normal anteroposterior shoulder radiographs were evaluated to determine the average values of the RSA angle, BCA, base plate orientation angle (BOA), and the base plate shoulder an

Increased scapular spine fractures after reverse shoulder arthroplasty with a humeral onlay short stem: an analysis of 485 consecutive cases.

BACKGROUND: Scapular stress fractures after reverse shoulder arthroplasty (RSA) are a potentially serious complication with modern lateralized and onlay implants. The aim of this study was to report the scapular spine stress fracture rate after RSA with an onlay, 145° humeral stem, analyzing potential fracture risk factors and clinical outcomes in a large cohort of patients. METHODS: A consecutive series of 485 RSAs were implanted with the Aequalis Ascend Flex stem. Data collection included preoperative and postoperative clinical and radiographic assessment findings (rotator cuff Goutallier g

Reverse Total Shoulder Arthroplasty without Bone-Grafting for Severe Glenoid Bone Loss in Patients with Osteoarthritis and Intact Rotator Cuff.

BACKGROUND: Treating shoulders with osteoarthritis, an intact rotator cuff, and substantial glenoid bone loss is challenging. One option is reaming the glenoid flat and inserting a reverse prosthesis. This study reports the subjective, objective, and radiographic results of reverse total shoulder arthroplasty (RTSA) in this population. METHODS: We retrospectively reviewed 42 consecutive patients (23 women; mean age, 71 years [range, 53 to 89 years]) with primary glenohumeral osteoarthritis, intact rotator cuffs, and Walch type-A2 (n = 19), B2 (n = 5), or C glenoids (n = 18) who had undergone

Mid-term survivorship analysis of a shoulder replacement with a keeled glenoid and a modern cementing technique.

We have investigated the mid-term outcome of total shoulder replacement using a keeled cemented glenoid component and a modern cementing technique with regard to the causes of failure and loosening of the components. Between 1997 and 2003 we performed 96 total shoulder replacements on 88 patients, 24 men and 64 women with a mean age of 69.7 years (31 to 82). The minimum follow-up was five years and at the time of review 87 shoulders (77 patients) were examined at a mean follow-up of 89.1 months (60 to 127). Cumulative survival curves were generated with re-operations (accomplished and planned)

Novel in vivo mouse model of shoulder implant infection.

BACKGROUND: Animal models are used to guide management of periprosthetic implant infections. No adequate model exists for periprosthetic shoulder infections, and clinicians thus have no preclinical tools to assess potential therapeutics. We hypothesize that it is possible to establish a mouse model of shoulder implant infection (SII) that allows noninvasive, longitudinal tracking of biofilm and host response through in vivo optical imaging. The model may then be employed to validate a targeting probe (1D9-680) with clinical translation potential for diagnosing infection and image-guided débrid

Reverse shoulder arthroplasty for the treatment of nonunions of the surgical neck of the proximal part of the humerus (type-3 fracture sequelae).

BACKGROUND: Fracture sequelae of the proximal part of the humerus are challenging conditions, and various treatment options have been described. The purpose of this multicenter study was to analyze the clinical and radiographic outcomes as well as the complications following semiconstrained reverse total shoulder arthroplasty for the treatment of nonunion of a surgical neck fracture of the proximal part of the humerus. METHODS: Thirty-two patients with a mean age of sixty-eight years (range, forty-eight to eighty-three years) managed with a reverse shoulder arthroplasty for the treatment of n

[Replacement of the Glenoid Using a Reconstruction Socket (EPOCA RECO].

OBJECTIVE: Alleviation of pain, restoration of function and active range of motion in the shoulder in case of cuff tear arthropathy. INDICATIONS: Cuff tear arthropathy with an insufficient coracoacromial arch and salvage operation of failed hemiprosthesis or reverse shoulder prosthesis. CONTRAINDICATIONS: Active or chronic infections. Lesions of the plexus. Insufficiency of deltoid muscle or subscapularis muscle. Neurologic diseases. Young active patients. SURGICAL TECHNIQUE: Deltopectoral approach. Resection of the humeral head and removal of the failed implant, respectively. Periarticular…

Destructive septic arthritis of shoulder in adults.

BACKGROUND: Late sequelae of septic arthritis of the glenohumeral joint are very rare and represent a potentially devastating condition that … underwent early surgical debridement. Five patients underwent delayed reconstruction with a reverse shoulder prosthesis, and at minimum 1-year follow-up, the mean Constant score was 56 (range 47-69) and mean DASH score was 33 (31-38). CONCLUSIONS: Antibiotic spacers are able to deliver antibiotics locally to the infected tissue while reducing the dead space and stab …

[Scapulohumeral arthrodesis for non-neurological shoulder: a study of 8 cases].

PURPOSE OF THE STUDY: Scapulohumeral arthrodesis is mainly used for the treatment of sequelar injury after brachial plexus palsy. Indications are however controversial and limited to patients with non-neurological shoulders. We report a series of eight shoulder arthrodeses performed on non-neurological shoulders in order to determine and detail the current role of this procedure. PATIENTS AND METHODS: The series included eight patients, five men and three women, mean age 47 years (23-87). The dominant side was operated on in two patients and the non-dominant side in six. Seven patients had ha

Source of lateralization in reverse total shoulder arthroplasty matters: a comparison of glenoid and humeral lateralization on rotator cuff biomechanics.

BACKGROUND: Compared with the traditional Grammont design, modern reverse total shoulder arthroplasty (rTSA) implant designs often introduce lateralization of the glenoid and/or humeral components. This study aimed to evaluate the impact of different strategies for achieving lateralization (ie, humeral or glenoid lateralization) in rTSA implant design on rotator cuff biomechanics. METHODS: Computed tomography scans from 16 nonosteoarthritic subjects were used to build customized computational 3-dimensional shoulder models based on the Newcastle Shoulder Model. Four rTSA implant constructs wer

The effect of different antibiotic combinations in calcium sulfate cement on the growth of Cutibacterium acnes and Staphylococcus periprosthetic shoulder infection isolates.

BACKGROUND: Periprosthetic joint infections (PJI) of the shoulder are a devastating complication of shoulder arthroplasty and are commonly caused by Staphylococcus and Cutibacterium acnes. Absorbable calcium sulfate (CS) beads are sometimes used for delivering antibiotics in PJI. This study evaluates the in vitro effect of different combinations of gentamicin, vancomycin, and ertapenem in beads made from CS cement on the growth of C acnes and coagulase-negative Staphylococcus (CNS) strains. METHODS: Three strains of C acnes and 5 strains of CNS from clinically proven shoulder PJI were culture

Total shoulder arthroplasty for glenohumeral arthritis associated with posterior glenoid bone loss: midterm results of an all-polyethylene, posteriorly augmented, stepped glenoid component.

BACKGROUND: The purpose of this study is to report the minimum 5-year clinical and radiographic outcomes of patients undergoing anatomic total shoulder arthroplasty (aTSA) with a posteriorly augmented glenoid component. METHODS: Thirty-five shoulders with minimum 5-year follow-up underwent aTSA using a posteriorly augmented glenoid component for the treatment of glenohumeral osteoarthritis with posterior glenoid bone loss. Clinical outcomes included range of motion, visual analog scale (VAS) for pain, and patient-reported outcomes scores. Radiographs and computed tomography scans were obtaine

BIO-RSA vs. metal-augmented baseplate in shoulder osteoarthritis with multiplanar glenoid deformity: a comparative study of radiographic findings and patient outcomes.

BACKGROUND: Reverse shoulder arthroplasty (RSA) requiring extensive reaming to address severe glenoid bone loss increases the risk of glenoid medialization and baseplate failure. We hypothesized that (1) metal-augmented baseplate prevents the medialization of the joint line and preserves glenoid bone stock similarly to bony increased-offset (BIO)-RSA and (2) bone graft viability and healing in BIO-RSA patients become compromised over time. MATERIALS AND METHODS: Eighty-one patients (83 shoulders) underwent glenoid lateralization with bone (BIO-RSA group, 44) or metal-augmented baseplate (meta

Symptomatic aseptic loosening of a short humeral stem following anatomic total shoulder arthroplasty.

INTRODUCTION: The rate of aseptic humeral component loosening with standard-length stems is historically so low (0.3%) that presence of humeral loosening was given substantial weight in defining periprosthetic shoulder infection by the International Consensus Meeting (ICM) in 2018. This study aims to confirm that the historically low rate of humeral stem aseptic loosening is not affected by the adoption of a novel short humeral stem. METHODS: Following institutional review board approval, this retrospective multi-institutional study was undertaken. A review of anatomic total shoulder arthropl

Proximal stress shielding is decreased with a short stem compared with a traditional-length stem in total shoulder arthroplasty.

BACKGROUND: This study compared the outcome and radiographic humeral adaptations after placement of a traditional-length (TL) or short-stem (SS) humeral component during total shoulder arthroplasty (TSA). The hypothesis was there would be no difference in outcome or radiographic adaptations. METHODS: A multicenter retrospective review was performed of primary TSAs performed with a TL or SS press-fit humeral component. The stems were identical in geometry and coating, with the only variable being stem length. Functional outcome and radiographs were reviewed at a minimum of 2 years postoperativ

Causes of acromion and scapular spine fractures following reverse shoulder arthroplasty: a retrospective analysis and literature review.

PURPOSE: Fractures of the acromion and the scapular spine are serious complications after reverse total shoulder arthroplasty. They concern about 4 to 5% of the patients and always result in a significant deterioration of shoulder function. Different causes have been taken into consideration, particularly stress or fatigue fractures. The purpose of the present study was to analyse our own cases and to discuss the causes reported in the literature. METHODS: We reviewed our shoulder arthroplasty registry and the consultation reports of the last ten years. The charts and radiographs of all patie

Modified latissimus dorsi and teres major transfer through a single delto-pectoral approach for external rotation deficit of the shoulder: as an isolated procedure or with a reverse arthroplasty.

Definitive loss of active external rotation of the shoulder impacts an individual's ability to perform ADL's, creating severe disability. To … ation (ILER) related to an irreparable postero-superior cuff tear. It was associated with a reverse shoulder prosthesis in 8 patients with combined loss of active elevation and external rotation (CLEER): 6 cases of rotator cuff tear arthropathy and 2 of tumor reconstruction. For the series as a whole, the mean increase in active elevation was 34.7 degrees . The gain …