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Acromial fractures common after RSA; effects can be mitigated
Although acromial fractures can be common after reverse shoulder arthroplasty, recently published data indicate their effects can be mitigated with proper management.
Study authors retrospectively reviewed 125 patients who underwent reverse shoulder arthroplasty (RSA) at a single institution between 2006 and 2011. Patients were divided into cohorts based on whether or not acromial stress fractures were present postoperatively. VAS, American Shoulder and Elbow Surgeons (ASES) score and Single Assessment Numeric Evaluation (SANE) score, as well as radiographic findings, arthritis presence in the acromioclavicular joint and motion metrics were all evaluated in both cohorts. Average postoperative follow-up was 19.7 months.
Overall, 14 patients (11.2%) were diagnosed with an acromial stress fracture following RSA. These fractures were observed at an average of 5.1 months postoperatively. Patients diagnosed with acromial fractures were observed to have worse postoperative forward elevation (116.6) before fracture than those without without fracture (143.5). Postoperative pain relief before fracture was also greater in the fracture cohort, according to the researchers.
The researchers found no significant differences between the cohorts for degree of arm lengthening or for the prevalence of degenerative acromioclavicular joint changes identified preoperatively.
In the fracture cohort, function was found to return to pre-fracture levels with proper management. – by Christian Ingram
Disclosure: The authors have no relevant financial disclosures.