PMID- 35183742
OWN - NLM
STAT- MEDLINE
DCOM- 20220524
LR  - 20220524
IS  - 1532-6500 (Electronic)
IS  - 1058-2746 (Linking)
VI  - 31
IP  - 6S
DP  - 2022 Jun
TI  - Acromial fractures following reverse shoulder arthroplasty: the role of the 
      acromial morphology and a comparison of clinical outcomes.
PG  - S34-S43
LID - S1058-2746(22)00226-9 [pii]
LID - 10.1016/j.jse.2022.01.132 [doi]
AB  - BACKGROUND: The purpose was to evaluate the relationship between acromial 
      morphology and the location of acromial fractures following reverse shoulder 
      arthroplasty and determine whether fracture location and displacement impact 
      clinical outcomes. METHODS: We performed a multicenter retrospective review of 
      reverse shoulder arthroplasties complicated by acromial fractures. Radiographs 
      were compared to determine the differences in acromial morphology, as well as 
      fracture orientation and pattern, between patients with Levy type I (n = 17) and 
      Levy type II (n = 25) fractures. Patients with a minimum of 2 years' follow-up 
      were selected to examine the association between clinical outcomes and fracture 
      location and displacement. Twenty-two patients were stratified based on whether 
      they achieved the minimal clinically important difference (MCID) in the American 
      Shoulder and Elbow Surgeons score (20 points). The groups were then compared 
      regarding fracture location and displacement using measurements such as the 
      acromiohumeral distance. RESULTS: The Levy type I group had a higher acromial 
      slope than the Levy type II group (127 degrees  vs. 117 degrees , P < .001). Levy type I 
      fractures had a transverse pattern occurring in the coronal plane, whereas Levy 
      type II fractures had an oblique pattern occurring in the sagittal plane 
      (P < .001). At final follow-up, 12 of 22 patients (55%) achieved the MCID. Those 
      who did not achieve the MCID had more displaced fractures including a lower 
      acromiohumeral distance (8 mm vs. 20 mm, P = .007). There was no difference in 
      the distribution of Levy type I and type II fractures based on the MCID cutoff 
      (P = .093). CONCLUSION: An increased acromial slope is associated with transverse 
      fractures in the Levy I region, whereas a lower acromial slope is associated with 
      oblique fractures in the Levy II region. Overall, 55% of patients achieved the 
      MCID at mid-term follow-up. The outcomes of those who did not achieve the MCID 
      became worse postoperatively, and this was associated with increased fracture 
      displacement.
CI  - Copyright (c) 2022 Journal of Shoulder and Elbow Surgery Board of Trustees. 
      Published by Elsevier Inc. All rights reserved.
FAU - Haidamous, Georges
AU  - Haidamous G
AD  - Shoulder Service, Florida Orthopaedic Institute, Tampa, FL, USA.
FAU - Merimee, Stephanie
AU  - Merimee S
AD  - Department of Orthopaedics and Sports Medicine, University of South Florida 
      Morsani College of Medicine, Tampa, FL, USA.
FAU - Simon, Peter
AU  - Simon P
AD  - Translational Research, Foundation for Orthopaedic Research and Education (FORE), 
      Tampa, FL, USA; Department of Medical Engineering, University of South Florida 
      College of Engineering and Morsani College of Medicine, Tampa, FL, USA.
FAU - Denard, Patrick J
AU  - Denard PJ
AD  - Southern Oregon Orthopedics, Oregon Shoulder Institute, Medford, OR, USA.
FAU - Ladermann, Alexandre
AU  - Ladermann A
AD  - Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, 
      Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland; 
      Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva 
      University Hospitals, Geneva, Switzerland.
FAU - Mighell, Mark A
AU  - Mighell MA
AD  - Shoulder Service, Florida Orthopaedic Institute, Tampa, FL, USA.
FAU - Gorman, R Allen 2nd
AU  - Gorman RA 2nd
AD  - Translational Research, Foundation for Orthopaedic Research and Education (FORE), 
      Tampa, FL, USA.
FAU - Frankle, Mark A
AU  - Frankle MA
AD  - Shoulder Service, Florida Orthopaedic Institute, Tampa, FL, USA; Department of 
      Orthopaedics and Sports Medicine, University of South Florida Morsani College of 
      Medicine, Tampa, FL, USA. Electronic address: mfrankle@floridaortho.com.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20220218
PL  - United States
TA  - J Shoulder Elbow Surg
JT  - Journal of shoulder and elbow surgery
JID - 9206499
SB  - IM
MH  - Acromion/diagnostic imaging/surgery
MH  - Arthroplasty/adverse effects
MH  - *Arthroplasty, Replacement, Shoulder/adverse effects
MH  - *Fractures, Bone/diagnostic imaging/etiology/surgery
MH  - Humans
MH  - Retrospective Studies
MH  - *Shoulder Joint/surgery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - MCID
OT  - Reverse shoulder arthroplasty
OT  - acromial slope
OT  - acromion
OT  - displacement
OT  - fracture
OT  - outcomes
EDAT- 2022/02/21 06:00
MHDA- 2022/05/25 06:00
CRDT- 2022/02/20 20:31
PHST- 2021/11/12 00:00 [received]
PHST- 2022/01/10 00:00 [revised]
PHST- 2022/01/16 00:00 [accepted]
PHST- 2022/02/21 06:00 [pubmed]
PHST- 2022/05/25 06:00 [medline]
PHST- 2022/02/20 20:31 [entrez]
AID - S1058-2746(22)00226-9 [pii]
AID - 10.1016/j.jse.2022.01.132 [doi]
PST - ppublish
SO  - J Shoulder Elbow Surg. 2022 Jun;31(6S):S34-S43. doi: 10.1016/j.jse.2022.01.132. 
      Epub 2022 Feb 18.