Reverse Shoulder Arthroplasty is Similar to Hemiarthroplasty to Manage Proximal Humeral Fractures in Elderly Patients: A Mid-Term Survival Retrospective Study

Julien Vignes1*, Cedric Maillot1 , Deborah Royaux1 and Bruno Zipoli2

CHU de Beaujon-Bichat - AP-HP, Paris, France 2 CH DAX, France

^*Correspondance to: Julien Vignes 

 PDF  Full Text DOI: 10.25107/2474-1647.2972

Abstract

Background: The aim of the study was, firstly, to compare the 1) functional and 2) radiological outcomes of RSA with HA in elderly patients with acute proximal humeral fractures, secondly to compare the 3) mid-term survival of these two types of arthroplasty. Methods: All patients treated by RSA or HA for acute proximal humeral fracture, in primary hospital center were retrospectively identified. The primary endpoint was absolute and weighted Constant-Murley score. We also performed a statistical survival analysis of Kaplan-Meier. Results: Forty-nine patients were included in the clinical and radiological analysis and 141 patients were included in the survival analysis. At the final follow-up, the absolute Constant Score was higher in the RSA group, but there was no significant difference between HA and RSA groups, respectively 57.4 ? 21.8 vs. 65 ? 17.1 (p=0.184). However, the weighted Constant score was clinically and statistically significantly better in the RSA group (HA: 81.16 ? 28.9 vs. RSA: 108.04 ? 27.6; p=0.001). The estimated mean survival time was 50 ? 6 months in the RSA group and 64 ? 8 months in the HA group. The analysis of the survival curve of Kaplan-Meier did not show any significant difference between the HA and RSA groups (p=0.11). Conclusion: By using an optimized surgical technique, with implants designed for trauma, RSA can be the first option in the management of complex proximal humeral fractures in patients older than 65.

Keywords

Hemiarthroplasty; Reverse shoulder arthroplasty; Survival rate; Functional outcome; Humeral fracture

Cite the article

Vignes J, Maillot C, Royaux D, Zipoli B. Reverse Shoulder Arthroplasty is Similar to Hemiarthroplasty to Manage Proximal Humeral Fractures in Elderly Patients: A Mid-Term Survival Retrospective Study. Clin Surg. 2020; 5: 2972.