Management of multidirectional instability.

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Abstract

[Indexed for MEDLINE] 18. Int Orthop. 2019 Jul;43(7):1653-1658. doi: 10.1007/s00264-018-4123-4. Epub 2018 Sep 3. Reverse shoulder arthroplasty for instability arthropathy. Clavert P(1), Kling A(2), Sirveaux F(3), Favard L(4), Mole D(3), Walch G(5), Boileau P(6). Author information: (1)Shoulder and Elbow Service HUS - CCOM, 10, Avenue Baumann, F-67400, Illkirch, France. philippe.clavert@chru-strasbourg.fr. (2)Shoulder and Elbow Service HUS - CCOM, 10, Avenue Baumann, F-67400, Illkirch, France. (3)Centre chirurgical Émile-Gallé, CHRU, 49, rue Hermite, 54000, Nancy, France. (4)Hôpital Trousseau, CHRU de Tours, avenue de la République, 37170, Chambray-lès-Tours, France. (5)Ramsey Générale de Santé Hôpital Privé Jean Mermoz, Lyon, France. (6)Department of Orthopaedic Surgery, iULS (Institut Universitaire Locomoteur & Sport), University of Nice Sophia Antipolis, Nice, France. PURPOSE: Osteoarthritis may be observed after surgery for instability and in the natural history of pathology. The primary objective was to analyze the late clinical and radiographic results of reverse shoulder arthroplasties (RSA) for patients who had instability arthropathy. METHODS: This is a retrospective cohort of 25 patients with a mean follow-up of 6.6 years. Patients had a history of instability surgery (80%) or multiple closed reductions. All were clinically evaluated with the constant score (CS), and radiologically (true AP view and Y view). RESULTS: No significant differences in pre- and post-operative function, radiologic status, and complication rate between the patients treated with a prior bone block procedure for the anterior instability and those treated by a capsular plication or non-operatively. A 36-mm sphere was implanted in 67%. Bone grafting of the glenoid was needed in 71%. No intra-operative complication has been reported. Clinically, the active anterior elevation increased from 70° to 140° (p