TY - JOUR
T1 - Results of closed management of acute dislocation after reverse shoulder arthroplasty
AU - Teusink, Matthew J.
AU - Pappou, Ioannis P.
AU - Schwartz, Daniel Grant
AU - Cottrell, Benjamin J.
AU - Frankle, Mark A.
N1 - Funding Information:
Funding: DJO Surgical provided research funding to the Foundation for Orthopaedic Research and Education for this study.
Publisher Copyright:
© 2015 Journal of Shoulder and Elbow Surgery Board of Trustees.
PY - 2015/4/1
Y1 - 2015/4/1
N2 - Background: Postoperative instability continues to be one of the most common complications limiting outcomes of reverse shoulder arthroplasty (RSA). The optimal management of this complication remains unknown. The purpose of this study was to evaluate the outcomes of patients with postoperative dislocation after RSA managed with closed reduction. Methods: All patients who were treated with a closed reduction for dislocation after RSA in the period between May 2002 and September 2011 were identified and retrospectively reviewed. Final outcomes including recurrent instability, need for revision surgery, American Shoulder and Elbow Surgeons outcome score, and range of motion were evaluated. Results: A total of 21 patients were identified. Nearly 50% of cases (10 of 21) had previous surgery, with 80% (8 of 10) of these being previous arthroplasty. The average time to first dislocation was 200days, with 62% (13 of 21) occurring in the first 90days. At average follow-up of 28months, 62% of these shoulders remained stable (13 of 21), 29% required revision surgery (6 of 21), and 9% remained unstable (2 of 21). The average American Shoulder and Elbow Surgeons score was 68.0 for patients treated with closed reduction for instability and 62.7 for those treated with revision surgery (P=.64). Discussion: This study shows that an initial dislocation episode after RSA with use of this implant can be successfully managed with closed reduction and temporary immobilization in more than half of cases. Given that outcomes after revision surgery are not different from those after closed treatment, we would continue to recommend an initial attempt at closed reduction in the office setting in all cases of postoperative RSA dislocation.
AB - Background: Postoperative instability continues to be one of the most common complications limiting outcomes of reverse shoulder arthroplasty (RSA). The optimal management of this complication remains unknown. The purpose of this study was to evaluate the outcomes of patients with postoperative dislocation after RSA managed with closed reduction. Methods: All patients who were treated with a closed reduction for dislocation after RSA in the period between May 2002 and September 2011 were identified and retrospectively reviewed. Final outcomes including recurrent instability, need for revision surgery, American Shoulder and Elbow Surgeons outcome score, and range of motion were evaluated. Results: A total of 21 patients were identified. Nearly 50% of cases (10 of 21) had previous surgery, with 80% (8 of 10) of these being previous arthroplasty. The average time to first dislocation was 200days, with 62% (13 of 21) occurring in the first 90days. At average follow-up of 28months, 62% of these shoulders remained stable (13 of 21), 29% required revision surgery (6 of 21), and 9% remained unstable (2 of 21). The average American Shoulder and Elbow Surgeons score was 68.0 for patients treated with closed reduction for instability and 62.7 for those treated with revision surgery (P=.64). Discussion: This study shows that an initial dislocation episode after RSA with use of this implant can be successfully managed with closed reduction and temporary immobilization in more than half of cases. Given that outcomes after revision surgery are not different from those after closed treatment, we would continue to recommend an initial attempt at closed reduction in the office setting in all cases of postoperative RSA dislocation.
KW - Case series
KW - Closed reduction
KW - Dislocation
KW - Level IV
KW - Nonoperative treatment
KW - Retrospective review
KW - Reverse shoulder arthroplasty
KW - Revision
KW - Treatment study
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U2 - 10.1016/j.jse.2014.07.015
DO - 10.1016/j.jse.2014.07.015
M3 - Article
C2 - 25441563
AN - SCOPUS:84925257790
VL - 24
SP - 621
EP - 627
JO - Journal of Shoulder and Elbow Surgery
JF - Journal of Shoulder and Elbow Surgery
SN - 1058-2746
IS - 4
ER -