The Effect of Tuberosity Healing on Functional Outcomes After Reverse Shoulder Arthroplasty for Proximal Humerus Fractures: a Systematic Review and Meta-analysis

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2024 Sep 9

PMID 39249532

Authors

Timothy R Buchanan

Akshay R Reddy

Victoria E Bindi

Keegan M Hones

Kara E Holt

Thomas W Wright

Bradley S Schoch

Jonathan O Wright

Scott G Kaar

Joseph J King

Kevin A Hao

Affiliations

Soon will be listed here.

Abstract

Purpose: This systematic review and meta-analysis compared clinical outcome measures in patients undergoing reverse shoulder arthroplasty (RSA) for proximal humerus fracture (PHF) with healed versus non-healed greater tuberosity (GT).

Methods: We performed a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines querying PubMed/MEDLINE, EMBASE, Web of Science, and Cochrane for studies that stratified results by the GT healing status. Studies that did not attempt to repair the GT were excluded. We extracted and compared clinical outcomes including postoperative forward flexion (FF), external rotation (ER), internal rotation (IR), Constant score, and complications and revision rates.

Results: Of the included patients, 295 (78.5%) demonstrated GT healing while 81 did not (21.5%). The healed GT cohort exhibited increased postoperative FF (P < .001), ER (P < .001), IR (P = .006), and Constant score (P = .006) compared to the non-healed GT cohort. The overall dislocation rate was 0.8% with no study differentiating GT status of dislocation cases.

Conclusion: Healing of the GT after RSA for PHF yields improved postoperative range of motion and strength, whereas patient-reported pain and function were largely not affected by GT healing indicating merit to RSA for PHF regardless of the likelihood of the GT healing.

Citing Articles

Greater Tuberosity Healing Rate and Clinical Results Following RSA Are Similar for Two Fracture-Specific Implant Systems.

Rotman D, Avraham O, Goldstein Y, Kazum E, Rojas Lievano J, Chechik O J Clin Med. 2024; 13(22).

PMID: 39598111 PMC: 11595365. DOI: 10.3390/jcm13226967.

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