CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(04): 529-539
DOI: 10.1055/s-0040-1721359
Artigo de Atualização
Ombro e Cotovelo

Artroplastia do ombro no tratamento das fraturas da extremidade proximal do úmero: Conceitos atuais[*]

Artikel in mehreren Sprachen: português | English
1   Centro de Cirurgia do Ombro e Cotovelo, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil
,
Marcus Vinícius Galvão Amaral
1   Centro de Cirurgia do Ombro e Cotovelo, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil
› Institutsangaben

Resumo

Fraturas complexas da extremidade proximal do úmero, especialmente em idosos, frequentemente necessitam de tratamento cirúrgico artroplástico. Tradicionalmente, a hemiartroplastia (HA) do ombro é o método de escolha, com longa sobrevida do implante, e oferece um ombro indolor, mas com resultados clínicos heterogêneos, relacionados ao correto posicionamento do implante quanto à altura e à versão, além da consolidação anatômica dos tubérculos. Atualmente, a utilização de artroplastias reversas do ombro para o tratamento dessas fraturas vêm aumentando exponencialmente, com melhores resultados funcionais do que as HAs, principalmente quanto à flexão anterior, apesar de a longevidade do implante ainda não ter sido estabelecida. O desenvolvimento de componentes umerais protéticos específicos para o tratamento de fraturas, introduzidos na prática clínica nos últimos anos, levou a resultados clínicos melhores.

* Trabalho desenvolvido no Centro de Cirurgia do Ombro e Cotovelo, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil.




Publikationsverlauf

Eingereicht: 24. August 2019

Angenommen: 16. September 2020

Artikel online veröffentlicht:
31. März 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 
  • Referências

  • 1 Kim SH, Szabo RM, Marder RA. Epidemiology of humerus fractures in the United States: nationwide emergency department sample, 2008. Arthritis Care Res (Hoboken) 2012; 64 (03) 407-414
  • 2 Neer II CS. Displaced proximal humeral fractures. I. Classification and evaluation. J Bone Joint Surg Am 1970; 52 (06) 1077-1089
  • 3 Maier D, Jaeger M, Izadpanah K, Strohm PC, Suedkamp NP. Proximal humeral fracture treatment in adults. J Bone Joint Surg Am 2014; 96 (03) 251-261
  • 4 Checchia SL, Doneux PS, Miyazaki AN. et al. Tratamento das fraturas do terço proximal do úmero com a prótese parcial Eccentra®. Rev Bras Ortop 2005; 40 (03) 130-140
  • 5 Murachovsky J, Ikemoto RY, Nascimento LG, Fujiki EN, Milani C, Warner JJ. Pectoralis major tendon reference (PMT): a new method for accurate restoration of humeral length with hemiarthroplasty for fracture. J Shoulder Elbow Surg 2006; 15 (06) 675-678
  • 6 Brandão BL, Amaral MV, Cohen M. et al. Osteossíntese das fraturas da extremidade proximal do úmero com sistema de placa de ângulo fixo com parafusos bloqueados: técnica e resultados. Rev Bras Ortop 2009; 44 (02) 106-111
  • 7 Boileau P, Winter M, Cikes A. et al. Can surgeons predict what makes a good hemiarthroplasty for fracture?. J Shoulder Elbow Surg 2013; 22 (11) 1495-1506
  • 8 Cadet ER, Ahmad CS. Hemiarthroplasty for three- and four-part proximal humerus fractures. J Am Acad Orthop Surg 2012; 20 (01) 17-27
  • 9 Robinson CM, Page RS, Hill RM, Sanders DL, Court-Brown CM, Wakefield AE. Primary hemiarthroplasty for treatment of proximal humeral fractures. J Bone Joint Surg Am 2003; 85 (07) 1215-1223
  • 10 Mighell MA, Kolm GP, Collinge CA, Frankle MA. Outcomes of hemiarthroplasty for fractures of the proximal humerus. J Shoulder Elbow Surg 2003; 12 (06) 569-577
  • 11 Bufquin T, Hersan A, Hubert L, Massin P. Reverse shoulder arthroplasty for the treatment of three- and four-part fractures of the proximal humerus in the elderly: a prospective review of 43 cases with a short-term follow-up. J Bone Joint Surg Br 2007; 89 (04) 516-520
  • 12 Dillon MT, Prentice HA, Burfeind WE, Chan PH, Navarro RA. The increasing role of reverse total shoulder arthroplasty in the treatment of proximal humerus fractures. Injury 2019; 50 (03) 676-680
  • 13 Jo YH, Lee KH, Lee BG. Surgical trends in elderly patients with proximal humeral fractures in South Korea: a population-based study. BMC Musculoskelet Disord 2019; 20 (01) 136
  • 14 Neer II CS. Displaced proximal humeral fractures. II. Treatment of three-part and four-part displacement. J Bone Joint Surg Am 1970; 52 (06) 1090-1103
  • 15 Boileau P, Sinnerton RJ, Chuinard C, Walch G. Arthroplasty of the shoulder. J Bone Joint Surg Br 2006; 88 (05) 562-575
  • 16 Garofalo R, Flanagin B, Castagna A, Lo EY, Krishnan SG. Reverse shoulder arthroplasty for proximal humerus fracture using a dedicated stem: radiological outcomes at a minimum 2 years of follow-up-case series. J Orthop Surg Res 2015; 10: 129
  • 17 Boileau P, Watkinson DJ, Hatzidakis AM, Balg F. Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elbow Surg 2005; 14 (1, Suppl S) 147S-161S
  • 18 Gerber C, Pennington SD, Nyffeler RW. Reverse total shoulder arthroplasty. J Am Acad Orthop Surg 2009; 17 (05) 284-295
  • 19 Sebastiá-Forcada E, Cebrián-Gómez R, Lizaur-Utrilla A, Gil-Guillén V. Reverse shoulder arthroplasty versus hemiarthroplasty for acute proximal humeral fractures. A blinded, randomized, controlled, prospective study. J Shoulder Elbow Surg 2014; 23 (10) 1419-1426
  • 20 Shukla DR, McAnany S, Kim J, Overley S, Parsons BO. Hemiarthroplasty versus reverse shoulder arthroplasty for treatment of proximal humeral fractures: a meta-analysis. J Shoulder Elbow Surg 2016; 25 (02) 330-340
  • 21 Wang J, Zhu Y, Zhang F, Chen W, Tian Y, Zhang Y. Meta-analysis suggests that reverse shoulder arthroplasty in proximal humerus fractures is a better option than hemiarthroplasty in the elderly. Int Orthop 2016; 40 (03) 531-539
  • 22 Bonnevialle N, Tournier C, Clavert P, Ohl X, Sirveaux F, Saragaglia D. la Société française de chirurgie orthopédique et traumatologique. Hemiarthroplasty versus reverse shoulder arthroplasty in 4-part displaced fractures of the proximal humerus: Multicenter retrospective study. Orthop Traumatol Surg Res 2016; 102 (05) 569-573
  • 23 Gallinet D, Ohl X, Decroocq L, Dib C, Valenti P, Boileau P. French Society for Orthopaedic Surgery (SOFCOT). Is reverse total shoulder arthroplasty more effective than hemiarthroplasty for treating displaced proximal humerus fractures in older adults? A systematic review and meta-analysis. Orthop Traumatol Surg Res 2018; 104 (06) 759-766
  • 24 Chen L, Xing F, Xiang Z. Effectiveness and safety of interventions for treating adults with displaced proximal humeral fracture: A network meta-analysis and systematic review. PLoS One 2016; 11 (11) e0166801
  • 25 Du S, Ye J, Chen H, Li X, Lin Q. Interventions for Treating 3- or 4-part proximal humeral fractures in elderly patient: A network meta-analysis of randomized controlled trials. Int J Surg 2017; 48: 240-246
  • 26 Cuff DJ, Pupello DR. Comparison of hemiarthroplasty and reverse shoulder arthroplasty for the treatment of proximal humeral fractures in elderly patients. J Bone Joint Surg Am 2013; 95 (22) 2050-2055
  • 27 Mata-Fink A, Meinke M, Jones C, Kim B, Bell JE. Reverse shoulder arthroplasty for treatment of proximal humeral fractures in older adults: a systematic review. J Shoulder Elbow Surg 2013; 22 (12) 1737-1748
  • 28 Baudi P, Campochiaro G, Serafini F. et al. Hemiarthroplasty versus reverse shoulder arthroplasty: comparative study of functional and radiological outcomes in the treatment of acute proximal humerus fracture. Musculoskelet Surg 2014; 98 (Suppl. 01) 19-25
  • 29 Ferrel JR, Trinh TQ, Fischer RA. Reverse total shoulder arthroplasty versus hemiarthroplasty for proximal humeral fractures: a systematic review. J Orthop Trauma 2015; 29 (01) 60-68
  • 30 Namdari S, Horneff JG, Baldwin K. Comparison of hemiarthroplasty and reverse arthroplasty for treatment of proximal humeral fractures: a systematic review. J Bone Joint Surg Am 2013; 95 (18) 1701-1708
  • 31 Simovitch RW, Roche CP, Jones RB. et al. Effect of Tuberosity Healing on Clinical Outcomes in Elderly Patients Treated With a Reverse Shoulder Arthroplasty for 3- and 4-Part Proximal Humerus Fractures. J Orthop Trauma 2019; 33 (02) e39-e45
  • 32 Chun YM, Kim DS, Lee DH, Shin SJ. Reverse shoulder arthroplasty for four-part proximal humerus fracture in elderly patients: can a healed tuberosity improve the functional outcomes?. J Shoulder Elbow Surg 2017; 26 (07) 1216-1221
  • 33 Torrens C, Alentorn-Geli E, Mingo F, Gamba C, Santana F. Reverse shoulder arthroplasty for the treatment of acute complex proximal humeral fractures: Influence of greater tuberosity healing on the functional outcomes. J Orthop Surg (Hong Kong) 2018; 26 (01) 2309499018760132
  • 34 Boileau P, Alta TD, Decroocq L. et al. Reverse shoulder arthroplasty for acute fractures in the elderly: is it worth reattaching the tuberosities?. J Shoulder Elbow Surg 2019; 28 (03) 437-444
  • 35 Ohl X, Bonnevialle N, Gallinet D. et al. SOFCOT. How the greater tuberosity affects clinical outcomes after reverse shoulder arthroplasty for proximal humeral fractures. J Shoulder Elbow Surg 2018; 27 (12) 2139-2144
  • 36 Torchia MT, Austin DC, Cozzolino N, Jacobowitz L, Bell JE. Acute versus delayed reverse total shoulder arthroplasty for the treatment of proximal humeral fractures in the elderly population: a systematic review and meta-analysis. J Shoulder Elbow Surg 2019; 28 (04) 765-773
  • 37 Seidl A, Sholder D, Warrender W. et al. Early Versus Late Reverse Shoulder Arthroplasty for Proximal Humerus Fractures: Does It Matter?. Arch Bone Jt Surg 2017; 5 (04) 213-220
  • 38 Hamilton MA, Diep P, Roche C. et al. Effect of reverse shoulder design philosophy on muscle moment arms. J Orthop Res 2015; 33 (04) 605-613
  • 39 Verdano MA, Aliani D, Galavotti C, Maroun C, Vaienti E, Ceccarelli F. Grammont versus lateralizing reverse shoulder arthroplasty for proximal humerus fracture: functional and radiographic outcomes. Musculoskelet Surg 2018; 102 (Suppl. 01) 57-65
  • 40 Sirveaux F, Roche O, Molé D. Shoulder arthroplasty for acute proximal humerus fracture. Orthop Traumatol Surg Res 2010; 96 (06) 683-694
  • 41 Barros LH, Figueiredo S, Marques M, Rodrigues C, Ramos J, Claro R. Tuberosity Healing after Reverse Shoulder Arthroplasty for Proximal Humerus Fractures: Is there Clinical Improvement? [Published online: 2020-02-07]. Rev Bras Ortop. Available from: https://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0039-3402459
  • 42 Schoch B, Aibinder W, Walters J. et al. Outcomes of Uncemented Versus Cemented Reverse Shoulder Arthroplasty for Proximal Humerus Fractures. Orthopedics 2019; 42 (02) e236-e241
  • 43 Dezfuli B, King JJ, Farmer KW, Struk AM, Wright TW. Outcomes of reverse total shoulder arthroplasty as primary versus revision procedure for proximal humerus fractures. J Shoulder Elbow Surg 2016; 25 (07) 1133-1137
  • 44 Gillespie R, Shishani Y, Joseph S, Streit JJ, Gobezie R. Neer Award 2015: A randomized, prospective evaluation on the effectiveness of tranexamic acid in reducing blood loss after total shoulder arthroplasty. J Shoulder Elbow Surg 2015; 24 (11) 1679-1684
  • 45 Kirsch JM, Bedi A, Horner N. et al. Tranexamic Acid in Shoulder Arthroplasty: A Systematic Review and Meta-Analysis. JBJS Rev 2017; 5 (09) e3
  • 46 Sun CX, Zhang L, Mi LD, Du GY, Sun XG, He SW. Efficiency and safety of tranexamic acid in reducing blood loss in total shoulder arthroplasty: A systematic review and meta-analysis. Medicine (Baltimore) 2017; 96 (22) e7015
  • 47 Noguera L, Trigo L, Melero V, Santana F, Torrens C. Reverse shoulder arthroplasty for acute proximal humeral fractures: Postoperative complications at 7 days, 90 days and 1 year. Injury 2019; 50 (02) 371-375
  • 48 Koh J, Galvin JW, Sing DC, Curry EJ, Li X. Thirty-day Complications and Readmission Rates in Elderly Patients After Shoulder Arthroplasty. J Am Acad Orthop Surg Glob Res Rev 2018; 2 (11) e068
  • 49 Lopiz Y, García-Coiradas J, Serrano-Mateo L, García-Fernández C, Marco F. Reverse shoulder arthroplasty for acute proximal humeral fractures in the geriatric patient: results, health-related quality of life and complication rates. Int Orthop 2016; 40 (04) 771-781
  • 50 Austin DC, Torchia MT, Cozzolino NH, Jacobowitz LE, Bell JE. Decreased Reoperations and Improved Outcomes With Reverse Total Shoulder Arthroplasty in Comparison to Hemiarthroplasty for Geriatric Proximal Humerus Fractures: A Systematic Review and Meta-Analysis. J Orthop Trauma 2019; 33 (01) 49-57
  • 51 Manoli A, Capriccioso CE, Konda SR, Egol KA. Total shoulder arthroplasty for proximal humerus fracture is associated with increased hospital charges despite a shorter length of stay. Orthop Traumatol Surg Res 2016; 102 (01) 19-24
  • 52 Liu JN, Agarwalla A, Gowd AK. et al. Reverse shoulder arthroplasty for proximal humerus fracture: a more complex episode of care than for cuff tear arthropathy. J Shoulder Elbow Surg 2019; 28 (11) 2139-2146
  • 53 Osterhoff G, O'Hara NN, D'Cruz J. et al. A Cost-Effectiveness analysis of reverse total shoulder arthroplasty versus hemiarthroplasty for the management of complex proximal humeral fractures in the elderly. Value Health 2017; 20 (03) 404-411
  • 54 Solomon JA, Joseph SM, Shishani Y. et al. Cost Analysis of Hemiarthroplasty Versus Reverse Shoulder Arthroplasty for Fractures. Orthopedics 2016; 39 (04) 230-234