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· DOS Abstracts
Risk of revision and reasons for revision after shoulder
replacement for acute fracture of the proximal
humerus: a Nordic registry-based study of 6,756
cases
Stig Brorson, Björn Salomonsson, Steen Lund Jensen, Anne Marie Fenstad, Yilmaz
Demir, Jeppe Vejlgaard Rasmussen
Department of Orthopaedic Surgery, Herlev University Hospital; Karolinska
Institutet, Danderyds Sjukhus AB, Stockholm, Sweden; Department of
Orthopaedic surgery, Aalborg University Hospital; Department of Orthopaedic
surgery, Haukeland University Hospital, Bergen, Norway; Karolinska Institutet,
Danderyds Sjukhus AB, Stockholm, Sweden; Department of Orthopaedic
Surgery, Herlev University Hospital
Background:
Stemmed shoulder hemiarthroplasty is a treatment option in
comminuted and displaced fractures of the proximal humerus. Within the last
decade reverse prostheses have been increasingly popular when fixation of the
tuberosities is considered impossible. There is a lack of reporting of risk of revi-
sion and reasons for revision for hemiarthroplasty and particularly for reverse
shoulder arthroplasty.
Purpose / Aim of Study:
Our primary aim was to report revision rates and
reasons for revision after shoulder replacement in acute fractures. Our second-
ary aim was to compare risk of revision, reasons for revision and risk of infection
between hemiarthroplasty and reverse prostheses.
Materials and Methods:
This study is based on a common data set established
through collaboration between the shoulder arthroplasty registries in Denmark,
Sweden, and Norway. It contains 6,756 shoulder replacements in acute frac-
tures inserted between 2004 and 2013.
Findings / Results:
Hemiarthroplasty was used in 90.4% of acute fractures
compared to 8.4% reverse prostheses. A total of 3.3% prostheses were re-
vised. Relative risk for revision of reverse shoulder arthroplasty compared to
hemiarthroplasty was 1.07 (p=0.24). In both designs the most common reason
for revision was infection. Relative risk for revision due to infection was 3.0
(p=0.001) in reverse shoulder arthroplasty compared to hemiarthroplasty. The
relative risk of revision was 2.8 in patients younger than 75 years (p=0.001).
Conclusions:
Reoperations after shoulder replacement in acute fractures are
rare, but the number of clinical failures might be underestimated if measured by
reoperations only. We found no significant difference in revision rate between
hemiarthroplasty and reverse arthroplasty. Early infection was more common
after reverse arthroplasty.
No conflicts of interest reported
91.