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Wang, Kevin, Agarwal, Amil, Best, Matthew, Mawn, John, Kamalapathy, Pramod, Srikumaran, Uma. (1401). A Comparison of Complications and Survivorship after Reverse Total Shoulder Arthroplasty for Proximal Humerus Fracture compared with Cuff Tear Arthropathy. , 11(3), 166-172. doi: 10.22038/abjs.2022.62599.3045
Kevin Y. Wang; Amil R. Agarwal; Matthew J. Best; John G. Mawn; Pramod Kamalapathy; Uma Srikumaran. "A Comparison of Complications and Survivorship after Reverse Total Shoulder Arthroplasty for Proximal Humerus Fracture compared with Cuff Tear Arthropathy". , 11, 3, 1401, 166-172. doi: 10.22038/abjs.2022.62599.3045
Wang, Kevin, Agarwal, Amil, Best, Matthew, Mawn, John, Kamalapathy, Pramod, Srikumaran, Uma. (1401). 'A Comparison of Complications and Survivorship after Reverse Total Shoulder Arthroplasty for Proximal Humerus Fracture compared with Cuff Tear Arthropathy', , 11(3), pp. 166-172. doi: 10.22038/abjs.2022.62599.3045
Wang, Kevin, Agarwal, Amil, Best, Matthew, Mawn, John, Kamalapathy, Pramod, Srikumaran, Uma. A Comparison of Complications and Survivorship after Reverse Total Shoulder Arthroplasty for Proximal Humerus Fracture compared with Cuff Tear Arthropathy. , 1401; 11(3): 166-172. doi: 10.22038/abjs.2022.62599.3045

A Comparison of Complications and Survivorship after Reverse Total Shoulder Arthroplasty for Proximal Humerus Fracture compared with Cuff Tear Arthropathy

The Archives of Bone and Joint Surgery
مقاله 4، دوره 11، شماره 3، خرداد 2023، صفحه 166-172    اصل مقاله (745.26 K)
نوع مقاله: RESEARCH PAPER
شناسه دیجیتال (DOI): 10.22038/abjs.2022.62599.3045
نویسندگان
Kevin Y. Wang1؛ Amil R. Agarwal* 2؛ Matthew J. Best3؛ John G. Mawn1؛ Pramod Kamalapathy4؛ Uma Srikumaran1
1Johns Hopkins Department of Orthopedic Surgery, Charter Drive, Columbia, USA
2Department of Orthopedic Surgery, George Washington School of Medicine and Health Sciences, Washington DC, USA
3Massachusetts General Hospital, Department of Orthopedic Surgery, Boston, MA, USA
4Department of Orthopedic Surgery, University of Virginia, Charlottesville, VA, USA
چکیده
Objectives: Traditionally used to treat rotator cuff tear arthropathy (CTA), reverse total shoulder 
arthroplasty (RTSA) is becoming increasingly utilized for the treatment of proximal humeral fractures 
(PHF). The purpose of this study was to use a matched cohort analysis to assess differences in 90 -day 
complications as well as 2-year and 5-year implant survival between patients undergoing RTSA for CTA 
and patients undergoing RTSA for PHF.
Methods: Patients with at least a 5-year follow-up who underwent primary RTSA for either PHF or CTA were 
identified in a national database (PearlDiver Technologies) using current procedural terminology (CPT) and 
international classification of diseases (ICD) 9 and 10 codes. Patients with a surgical indication of PHF were matched 
with patients with a surgical indication of CTA based on age, sex, Charlson Comorbidity Index, smoking status, and 
obesity (body mass index (BMI)>30). All-cause revision at the 2-year and 5-year postoperative time intervals were 
assessed. Reimbursements for the surgical care episode up to the 30-day, 90-day, and 1-year postoperative 
intervals were also assessed. Bivariate analysis was performed with a significance set at P<0.05.
Results: In total, 802 PHF patients were matched with 802 CTA patients. Compared to CTA patients, PHF patients 
undergoing RTSA were significantly at increased risk of atrial fibrillation, anemia, and heart failure within 90 days of 
surgery. Notably, there was no significant difference in all-cause revision surgery at 2-year and 5-year postoperative 
intervals or hospital reimbursements at the 30-day, 90-day, and 1-year postoperative intervals. 
Conclusion: Preoperative indication appears to be an important driver of healthcare utilization for RTSA, as PHF 
patients undergoing RTSA have a higher risk of short-term postoperative complications compared to CTA patients. 
However, there is no difference in hospital reimbursement for the two indications of RTSA, suggesting that current 
payment modalities may not appropriately adjust for risk based on the surgical indication.
 Level of evidence: III
کلیدواژه‌ها
CTA؛ PHF؛ Reverse total shoulder arthroplasty؛ RTSA؛ Proximal humeral fractures؛ Rotator cuff tear arthropathy؛ Surgical indications
مراجع
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  11. Hasty EK, Jernigan EW 3rd, Soo A, Varkey DT, Kamath GV. Trends in Surgical Management and Costs for Operative Treatment of Proximal Humerus Fractures in the Elderly. Orthopedics. 2017; 40(4):e641-e647. doi: 10.3928/01477447-20170411-03.
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آمار
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