PMID- 34904964 OWN - NLM STAT- MEDLINE DCOM- 20220421 LR - 20230815 IS - 1528-1132 (Electronic) IS - 0009-921X (Print) IS - 0009-921X (Linking) VI - 480 IP - 5 DP - 2022 May 1 TI - Improved Clinical Outcomes After Lateralized Reverse Shoulder Arthroplasty: A Systematic Review. PG - 949-957 LID - 10.1097/CORR.0000000000002065 [doi] AB - BACKGROUND: Lateralized reverse shoulder arthroplasty (RSA) has emerged as an attempt to improve on some of the drawbacks of conventional RSA, such as glenoid notching and decrease in ROM. Although this new design is being used in clinical practice, the evidence is mostly limited to case series and has not been systematically reviewed. QUESTIONS/PURPOSES: (1) How much did patient-reported outcome measures (PROMs) and ROM improve among patients who receive a lateralized RSA implant? (2) What proportion of shoulders experience complications, revision surgery, or scapular notching? METHODS: The PubMed and EMBASE databases were searched from database inception to January 31, 2020. We included clinical studies that reported the PROMs and/or ROM of patients with insufficient rotator cuffs undergoing RSA with a lateralized implant. All other types of studies and those including patients with fractures, instability or escape, infection, rheumatologic disease, neurologic disease, or revision surgeries as an indication for RSA were excluded. PROMs and ROM were collected and are reported as mean values and ranges. Complications, revision surgery, and scapular notching are presented as proportions. The percentage of the mean change relative to the minimum clinically important difference (MCID) was calculated using the anchor-based value for each outcome. The Methodological Index for Non-randomized Studies (MINORS) was used to assess study quality. The initial search yielded 678 studies; 61 full-text articles were analyzed according to our eligibility criteria. After a detailed analysis, we included nine studies that evaluated 1670 patients (68% of whom [1130] were women) with a mean age of 71.8 +/- 0.6 years. The mean follow-up period was 41.1 +/- 5.6 months. The mean MINORS score was 12 +/- 4. RESULTS: Active ROM improved for forward flexion (mean change 47 degrees to 82 degrees ; MCID 12 degrees ), abduction (mean change 43 degrees to 80 degrees ; MCID 7 degrees ), external rotation (mean change 8 degrees to 39 degrees ; MCID 3 degrees ), and internal rotation (mean change -2 to 1 points). PROM scores also improved, including the American Shoulder and Elbow Surgeons score (mean change 20 to 50; MCID 20.9 points), Constant score (mean change 28 to 40; MCID 5.7 points), Simple Shoulder Test score (mean change 3 to 7; MCID 2.4 points), and VAS score (mean change -1.8 to -4.9; MCID -1.6 points). The proportion of shoulders with complications ranged from 0% (0 of 44) to 21% (30 of 140), and the proportion of shoulders with scapular notching ranged from 0% (0 of 76) to 29% (41 of 140). The proportion of patients undergoing revision ranged from 0% (0 of 44) to 13% (10 of 76) at short-term follow-up. CONCLUSION: Lateralized RSA is a reasonable alternative to medialized implants for patients with rotator cuff insufficiency because it might reduce the likelihood of scapular notching without apparently compromising PROMs or ROM. More studies are required to determine whether there is a direct correlation between the amount of lateralization and PROMs or ROM. CI - Copyright (c) 2021 by the Association of Bone and Joint Surgeons. FAU - Nunes, Joni AU - Nunes J AD - Hospital de Braga, Braga, Portugal. AD - Clinica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal. AD - Dom Henrique Research Centre, Porto, Portugal. AD - School of Medicine, University of Minho, Braga, Portugal. AD - Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, Porto, Portugal. AD - Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal. AD - Hospital dos SAMS de Lisboa, Lisbon, Portugal. AD - Clinica GIGA Saude, Lisbon, Portugal. AD - School of Medicine and ICVS/3B's PT Government Associate Laboratory, University of Minho, Braga, Portugal. AD - Trofa Saude Group - Braga, Portugal. AD - Hospital Santa Maria Maior, Barcelos, Portugal. AD - Fundacion Jimenez Diaz, Universidad Autonoma de Madrid, Madrid, Spain. AD - 3Bs Research Group - Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimaraes, Portugal. AD - Trofa Saude Group - Hospital Central, Vila do Conde, Portugal. AD - Centro Hospitalar Medio Ave, Famalicao, Portugal. FAU - Andrade, Renato AU - Andrade R AD - Clinica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal. AD - Dom Henrique Research Centre, Porto, Portugal. AD - Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, Porto, Portugal. FAU - Azevedo, Clara AU - Azevedo C AUID- ORCID: 0000-0002-8526-9871 AD - Hospital de Braga, Braga, Portugal. AD - Clinica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal. AD - Dom Henrique Research Centre, Porto, Portugal. AD - School of Medicine, University of Minho, Braga, Portugal. AD - Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, Porto, Portugal. AD - Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal. AD - Hospital dos SAMS de Lisboa, Lisbon, Portugal. AD - Clinica GIGA Saude, Lisbon, Portugal. AD - School of Medicine and ICVS/3B's PT Government Associate Laboratory, University of Minho, Braga, Portugal. AD - Trofa Saude Group - Braga, Portugal. AD - Hospital Santa Maria Maior, Barcelos, Portugal. AD - Fundacion Jimenez Diaz, Universidad Autonoma de Madrid, Madrid, Spain. AD - 3Bs Research Group - Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimaraes, Portugal. AD - Trofa Saude Group - Hospital Central, Vila do Conde, Portugal. AD - Centro Hospitalar Medio Ave, Famalicao, Portugal. FAU - Ferreira, Nuno V AU - Ferreira NV AD - School of Medicine, University of Minho, Braga, Portugal. FAU - Oliveira, Nuno AU - Oliveira N AD - Hospital de Braga, Braga, Portugal. AD - School of Medicine, University of Minho, Braga, Portugal. FAU - Calvo, Emilio AU - Calvo E AD - Fundacion Jimenez Diaz, Universidad Autonoma de Madrid, Madrid, Spain. FAU - Espregueira-Mendes, Joao AU - Espregueira-Mendes J AD - Clinica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal. AD - Dom Henrique Research Centre, Porto, Portugal. AD - School of Medicine and ICVS/3B's PT Government Associate Laboratory, University of Minho, Braga, Portugal. AD - 3Bs Research Group - Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimaraes, Portugal. FAU - Sevivas, Nuno AU - Sevivas N AUID- ORCID: 0000-0002-6573-0368 AD - School of Medicine, University of Minho, Braga, Portugal. AD - School of Medicine and ICVS/3B's PT Government Associate Laboratory, University of Minho, Braga, Portugal. AD - Trofa Saude Group - Hospital Central, Vila do Conde, Portugal. AD - Centro Hospitalar Medio Ave, Famalicao, Portugal. LA - eng PT - Journal Article PT - Systematic Review DEP - 20211213 PL - United States TA - Clin Orthop Relat Res JT - Clinical orthopaedics and related research JID - 0075674 SB - IM CIN - Clin Orthop Relat Res. 2022 Jan 26;:. PMID: 35081082 MH - Aged MH - *Arthroplasty, Replacement, Shoulder/adverse effects MH - Female MH - Humans MH - Male MH - Range of Motion, Articular MH - Retrospective Studies MH - *Shoulder Joint/diagnostic imaging/surgery MH - *Shoulder Prosthesis MH - Treatment Outcome PMC - PMC9007193 COIS- Each author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research(R) editors and board members are on file with the publication and can be viewed on request. EDAT- 2021/12/15 06:00 MHDA- 2022/04/22 06:00 PMCR- 2023/05/01 CRDT- 2021/12/14 12:19 PHST- 2021/04/18 00:00 [received] PHST- 2021/11/05 00:00 [accepted] PHST- 2021/12/15 06:00 [pubmed] PHST- 2022/04/22 06:00 [medline] PHST- 2021/12/14 12:19 [entrez] PHST- 2023/05/01 00:00 [pmc-release] AID - 00003086-202205000-00017 [pii] AID - CORR-D-21-00677 [pii] AID - 10.1097/CORR.0000000000002065 [doi] PST - ppublish SO - Clin Orthop Relat Res. 2022 May 1;480(5):949-957. doi: 10.1097/CORR.0000000000002065. Epub 2021 Dec 13.