Weissinger M, Helmreich C, Teumann E
Orthopaedic Centre of the Landesklinikum Waldviertel Zwettl, Austria.
Acta Chir Orthop Traumatol Cech. 2008 Feb;75(1):21-7.
The aim of our retrospective study is to show that in cases of very serious degenerative alteration of the shoulder as well as massive Cuff arthropathy, there is a valid reason for the indication of an inverse prosthesis of the total shoulder joint. We therefore describe operation technique as well as evaluation of our own results, including complications.
From October 2000 to October 2005, 24 patients had 25 Delta prostheses implanted. All these 25 implantations were carried out by the author personally, using the Delta prosthesis, in Hybrid technique.
In all 25 implantations we used a lateral access by splitting the Deltoideus. We implanted the Glenoid component cement free, and we cemented the prosthesis of the Humerus in all our cases. After an average post-operational examination time of 3 years and 9 month, we examined clinically and radiologically, 23 patients (92%) with 24 implants. Pain, mobility and activity in every-day life were considered in the clinical post-operative check up.
Evaluation of pain showed that 14 patients (60,9 %) were free from pain and 9 patients (39,1 %) showed a great improvement in their medical state. In all cases we could clearly see that as far as mobility and activity in every-day life were concerned, a significant improvement hat occurred. The post-operative rate of complications showed the figure of 2 luxations (8 %). The luxation of the first patient could be repositioned in a non-operative way. The second patient was reoperated twice and we exchanged the shaft of the Humerus. In no instance did we discover any obstacle to the healing of wounds or any infections.
When the indication is carefully handled the inverse prosthesis of the shoulder is an excellent way of treatment of serious degenerative alteration of the shoulder joint and major Cuff arthropathy. The operation, which is technically demanding, should only be carried out by an operator experienced in shoulder operations. The rate of luxations can certainly be lowered with the accumulation of experience and strict adherence to the precise way in technique called for by this operation.
With elderly patients the inverse shoulder prosthesis is a good alternative way of treatment of serious degenerative alteration of the shoulder and massive Cuff arthropathy.
