PMID- 33616421
OWN - NLM
STAT- MEDLINE
DCOM- 20210510
LR  - 20210510
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 103-B
IP  - 5
DP  - 2021 May
TI  - Reverse total shoulder arthroplasty.
PG  - 813-821
LID - 10.1302/0301-620X.103B.BJJ-2020-2101 [doi]
AB  - AIMS: This systematic review asked which patterns of complications are associated 
      with the three reverse total shoulder arthroplasty (RTSA) prosthetic designs, as 
      classified by Routman et al, in patients undergoing RTSA for the management of 
      cuff tear arthropathy, massive cuff tear, osteoarthritis, and rheumatoid 
      arthritis. The three implant design philosophies investigated were medial 
      glenoid/medial humerus (MGMH), medial glenoid/lateral humerus (MGLH), and lateral 
      glenoid/medial humerus (LGMH). METHODS: A systematic review of the literature was 
      performed via a search of MEDLINE and Embase. Two reviewers extracted data on 
      complication occurrence and patient-reported outcome measures (PROMs). 
      Meta-analysis was conducted on the reported proportion of complications, weighted 
      by sample size, and PROMs were pooled using the reported standardized mean 
      difference (SMD). Quality of methodology was assessed using Wylde's non-summative 
      four-point system. The study was registered with PROSPERO (CRD42020193041). 
      RESULTS: A total of 42 studies met the inclusion and exclusion criteria. Rates of 
      scapular notching were found to be significantly higher in MGMH implants (52% 
      (95% confidence interval (CI) 40 to 63)) compared with MGLH ((18% (95% CI 6 to 
      34)) and LGMH (12% (95% CI 3 to 26)). Higher rates of glenoid loosening were seen 
      in MGMH implants (6% (95% CI 3 to 10)) than in MGLH implants (0% (95% CI 0 to 
      2)). However, strength of evidence for this finding was low. No significant 
      differences were identified in any other complication, and there were no 
      significant differences observed in PROMs between implant philosophies. 
      CONCLUSION: This systematic review has found significant improvement in PROMS and 
      low complication rates across the implant philosophies studied. Scapular notching 
      was the only complication found definitely to have significantly higher 
      prevalence with the MGMH implant design. Cite this article: Bone Joint 
      J 2021;103-B(5):813-821.
FAU - Burden, Eleanor G
AU  - Burden EG
AD  - Royal Devon and Exeter Foundation Trust, Exeter, UK.
FAU - Batten, Timothy J
AU  - Batten TJ
AD  - Royal Devon and Exeter Foundation Trust, Exeter, UK.
FAU - Smith, Christopher D
AU  - Smith CD
AD  - Royal Devon and Exeter Foundation Trust, Exeter, UK.
FAU - Evans, Jonathan P
AU  - Evans JP
AD  - Royal Devon and Exeter Foundation Trust, Exeter, UK.
AD  - Health Services and Policy Research Unit, University of Exeter Medical School, 
      Exeter, UK.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20210222
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
SB  - IM
MH  - Arthroplasty, Replacement, Shoulder/*methods
MH  - Humans
MH  - Patient Reported Outcome Measures
MH  - Postoperative Complications
MH  - Prosthesis Design
MH  - Shoulder Prosthesis
OTO - NOTNLM
OT  - Complications
OT  - Outcomes
OT  - RTSA
OT  - Reverse total shoulder arthroplasty
EDAT- 2021/02/23 06:00
MHDA- 2021/05/11 06:00
CRDT- 2021/02/22 12:12
PHST- 2021/02/23 06:00 [pubmed]
PHST- 2021/05/11 06:00 [medline]
PHST- 2021/02/22 12:12 [entrez]
AID - 10.1302/0301-620X.103B.BJJ-2020-2101 [doi]
PST - ppublish
SO  - Bone Joint J. 2021 May;103-B(5):813-821. doi: 
      10.1302/0301-620X.103B.BJJ-2020-2101. Epub 2021 Feb 22.