Shoulder Arthrodesis: A New Technique
- Authors: Voronkevich I.A.1, Varfolomeev A.P.1, Geraschenko N.I.2
-
Affiliations:
- Vreden National Medical Research Center of Traumatology and Orthopedics
- New Clinic ABIA
- Issue: Vol 28, No 1 (2022)
- Pages: 100-109
- Section: Modern technologies in traumatology and orthopedics
- URL: https://journals.rcsi.science/2311-2905/article/view/124908
- DOI: https://doi.org/10.17816/2311-2905-1683
- ID: 124908
Cite item
Abstract
Background. The replacement of fusion by arthroplasty in terminal shoulder arthropathies has led to the emergence of cases contraindicated for revision arthroplasty. Performing fusion by traditional methods in such cases is extremely risky because of unfavorable conditions: absence of the humeral head, thinning of the metaphysis walls, and defects of the glenoid. Thus, the creation of a new shoulder fusion technique is necessary.
The study aimed to show the possibilities of a new shoulder fusion technique in treating arthroplasty complications and terminal shoulder arthropathies.
The surgical procedure includes the resection of the shoulder joint and internal fixation with a special device containing a scapular fork with four locking screws and a bone plate. The fork was put on the scapular spine from the side of its notch and was blocked by four tightening screws, which clamped the scapular spine in the fork. The bone plate fixed the diaphysis of the humerus. The fixator form set the scapulohumeral ratio for the formation of ankylosis in a functional position. Bone grafting was performed with a graft from the wing of the iliac bone according to the special technique after endoprosthesis removal or with the resected head of the humerus in case of arthrosis.
Conclusions. The developed technique can be used as a standard revision option for contraindications to shoulder arthroplasty and for any traditional indications for its fusion, such as oncological resections, consequences of open and gunshot trauma, lesions of the brachial plexus, and terminal arthropathies in persons engaged in heavy physical labor when it is impossible to change profession.
Full Text
##article.viewOnOriginalSite##About the authors
Igor A. Voronkevich
Vreden National Medical Research Center of Traumatology and Orthopedics
Author for correspondence.
Email: dr_voronkevich@inbox.ru
ORCID iD: 0000-0001-8471-8797
Dr. Sci. (Med.)
Russian Federation, 8, Akademika Baykova str., St. Petersburg, 195427Alexander P. Varfolomeev
Vreden National Medical Research Center of Traumatology and Orthopedics
Email: doctor_varf@mail.ru
ORCID iD: 0000-0002-7710-1024
Cand. Sci. (Med.)
Russian Federation, 8, Akademika Baykova str., St. Petersburg, 195427Nikita I. Geraschenko
New Clinic ABIA
Email: gerashchenko@gmail.com
ORCID iD: 0000-0002-0781-4619
врач травматолог- ортопед
Russian Federation, St. PetersburgReferences
- Shukla D.R., McAnany S., Kim J., Overley S., Parsons B.O. Hemiarthroplasty versus reverse shoulder arthroplasty for treatment of proximal humeral fractures: a meta-analysis. J Shoulder Elbow Surg. 2016;25(2):330-340. doi: 10.1016/j.jse.2015.08.030.
- Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). Hip, Knee & Shoulder Arthroplasty: 2020 Annual Report. Adelaide: AOA, 2020.
- Ненашев Д.В., Варфоломеев А.П., Майков С.В. Анализ отдаленных результатов эндопротезирования плечевого сустава. Травматология и ортопедия России. 2012;18(2):71-78. doi: 10.21823/2311-2905-2012--2-71-78. Nenashev D.V., Varfolomeev A.P., Maykov S.V. [Analysis of long-term results of shoulder arthroplasty] Travmatologiya i ortopediya Rossii [Traumatology and Orthopedics of Russia]. 2012;18(2):71-78. (In Russian). doi: 10.21823/2311-2905-2012--2-71-78.
- Доколин С.Ю., Варфоломеев А.П., Кузьмина В.И., Артюх В.А., Марченко И.В. Среднесрочные результаты реверсивного эндопротезирования у пациентов с артропатией плеча после массивного разрыва вращательной манжеты. Травматология и ортопедия России. 2018;24(2):7-18. doi: 10.21823/2311-2905-2018-24-2-7-18. Dokolin S.Yu., Varfolomeev A.P., Kuzmina V.I., Artyukh V.A., Marchenko I.V. [Outcomes of Reverse arthroplasty in patients with Shoulder arthropathy and Massive Rotator cuff Tear]. Travmatologiya i ortopediya Rossii [Traumatology and Orthopedics of Russia]. 2018;24(2):7-18. (In Russian). doi: 10.21823/2311-2905-2018-24-2-7-18.
- Майков С.В. Эволюция эндопротезирования плечевого сустава. Вестник травматологии и ортопедии им. Н.Н. Приорова. 2020;27(1):84-90. doi: 10.17816/vto202027184-90. Maykov S.V. [Evolution of shoulder arthroplasty]. Vestnik travmatologii i ortopedii imeni N.N. Priorova [N.N. Priorov Journal of Traumatology and Orthopedics]. 2020;27(1):84-90. (In Russian). doi: 10.17816/vto202027184-90.
- Scalise J.J., Iannotti J.P. Glenohumeral arthrodesis after failed prosthetic shoulder arthroplasty. Surgical technique. J Bone Joint Surg Am. 2009;91 Suppl 2 Pt 1:30-37. doi: 10.2106/JBJS.H.01249.
- Gregory T., Hansen U., Taillieu F., Baring T., Brassart N., Mutchler C. et al. Glenoid loosening after total shoulder arthroplasty: an in vitro CT-scan study. J Orthop Res. 2009;27(12):1589-1595. doi: 10.1002/jor.20912.
- Dillon M.T., Page R.S., Graves S.E., Lorimer M.F., Prentice H.A., Harris J.E. et al. Early revision in anatomic total shoulder arthroplasty in osteoarthritis: a cross-registry comparison. Shoulder Elbow. 2020; 12(1 Suppl):81-87. doi: 10.1177/1758573219842168.
- Gauci M.O., Cavalier M., Gonzalez J.F., Holzer N., Baring T., Walch G. et al. Revision of failed shoulder arthroplasty: epidemiology, etiology, and surgical options. J Shoulder Elbow Surg. 2020;29(3):541-549. doi: 10.1016/j.jse.2019.07.034.
- González-Díaz R., Rodríguez-Merchán E.C., Gilbert M.S. The role of shoulder fusion in the era of arthroplasty. Int Orthop. 1997;21(3):204-209. doi: 10.1007/s002640050151.
- Воронкевич И.А., Варфоломеев А.П., Геращенко Н.И. Артродез плечевого сустава с использованием оригинального фиксатора. Актуальные проблемы травматологии и ортопедии: cборн. науч. статей посвящ. 110-летию РНИИТО им. Р.Р. Вредена. Санкт-Петербург; 2016. c. 40-46. Режим доступа: https://elibrary.ru/item.asp?id=28791371. Voronkevich I.A., Varfolomeev A.P., Gerashchenko N.I. [Arthrodesis of the shoulder joint using an original fixator]. [Actual problems of traumatology and orthopedics: collection of articles. scientific. articles dedicated. 110-th anniversary of the RNIITO them. R.R. Vreden]. St. Petersburg; 2016. р. 40-46. (In Russian) Available from: https://elibrary.ru/item.asp?id=28791371.
- Boyer P., Huten D., Alnot J.Y. [Bipolar shoulder prosthesis for rheumatoid arthritis with irreparable rotator cuff tear: results after 5 years’ follow-up]. Rev Chir Orthop Reparatrice Appar Mot. 2006;92(6):556-566. (In French).
- Alta T.D., Willems W.J. Once an arthrodesis, always an arthrodesis? J Shoulder Elbow Surg. 2016;25(2):232-237. doi: 10.1016/j.jse.2015.07.010.
- Dogger M.N., van Bemmel A.F., Alta T.D.W., van Noort A. Conversion to reverse shoulder arthroplasty fifty-one years after shoulder arthrodesis: A case report. World J Orthop. 2020;11(10):465-472. doi: 10.5312/wjo.v11.i10.465.
- Boileau P., Watkinson D.J., Hatzidakis A.M., Balg F. Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elbow Surg. 2005;14 (1 Suppl S):147S-161S. doi: 10.1016/j.jse.2004.10.006.
- Wilde A.H., Brems J.J., Boumphrey F.R. Arthrodesis of the shoulder. Current indications and operative technique. Orthop Clin North Am. 1987;18(3):463-472.
- Moeini S., Rasmussen J.V., Salomonsson B., Domeij-Arverud E., Fenstad A.M., Hole R. et al. Reverse shoulder arthroplasty has a higher risk of revision due to infection than anatomical shoulder arthroplasty: 17 730 primary shoulder arthroplasties from the Nordic Arthroplasty Register Association. Bone Joint J. 2019;101-B(6):702-707. doi: 10.1302/0301-620X.101B6.BJJ-2018-1348.R1.
- Atlan F., Durand S., Fox M., Levy P., Belkheyar Z., Oberlin C. Functional outcome of glenohumeral fusion in brachial plexus palsy: a report of 54 cases. J Hand Surg Am. 2012;37(4):683-688. doi: 10.1016/j.jhsa.2012.01.012.
- Dimmen S., Madsen J.E. Long-term outcome of shoulder arthrodesis performed with plate fixation: 18 patients examined after 3-15 years. Acta Orthop. 2007;78(6):827-833. doi: 10.1080/17453670710014626.
- Rühmann O., Schmolke S., Bohnsack M., Flamme C., Wirth C.J. Shoulder arthrodesis: indications, technique, results, and complications. J Shoulder Elbow Surg. 2005;14(1):38-50. doi: 10.1016/j.jse.2004.05.008.
- Thangarajah T., Alexander S., Bayley I., Lambert S.M. Glenohumeral arthrodesis for the treatment of recurrent shoulder instability in epileptic patients. Bone Joint J. 2014;96-B(11):1525-1529. doi: 10.1302/0301-620X.96B11.33754.
- Diaz J.A., Cohen S.B., Warren R.F., Craig E.V., Allen A.A. Arthrodesis as a salvage procedure for recurrent instability of the shoulder. J Shoulder Elbow Surg. 2003;12(3): 237-241. doi: 10.1016/s1058-2746(02)86883-5.
- Tomaino M.M. Scapulohumeral arthrodesis for post-traumatic proximal humeral loss using vascularized fibular transplantation and allograft bone. J Reconstr Microsurg. 2000;16(5):335-340. doi: 10.1055/s-2000-7342.
- Chammas M., Goubier J.N., Coulet B., Reckendorf G.M., Picot M.C., Allieu Y. Glenohumeral arthrodesis in upper and total brachial plexus palsy. A comparison of functional results. J Bone Joint Surg Br. 2004;86(5):692-695. doi: 10.1302/0301-620x.86b5.13549.
- Zsoldos C.M., Basamania C.J., Bal G.K. Shoulder fusion after a self-inflicted gunshot wound: an injury pattern and treatment option. Bone Joint J. 2013;95-B(6):820-824. doi: 10.1302/0301-620X.95B6.31447.
- Mimata Y., Nishida J., Sato K., Suzuki Y., Doita M. Glenohumeral arthrodesis for malignant tumor of the shoulder girdle. J Shoulder Elbow Surg. 2015;24(2):174-178. doi: 10.1016/j.jse.2014.05.023.
- Porcellini G., Savoie F.H. 3rd, Campi F., Merolla G., Paladini P. Arthroscopically assisted shoulder arthrodesis: is it an effective technique? Arthroscopy. 2014;30(12):1550-1556. doi: 10.1016/j.arthro.2014.06.026.
- Lenoir H., Williams T., Griffart A., Lazerges C., Chammas M., Coulet B. et al. Arthroscopic arthrodesis of the shoulder in brachial plexus palsy. J Shoulder Elbow Surg. 2017;26(5):e115-e121. doi: 10.1016/j.jse.2016.09.040.
Supplementary files
