Abstract | BACKGROUND: METHODS: We searched MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, and 3 clinical trials registries. We included all studies treating proximal humeral fractures with RSA in adults with a mean age older than 60 years and 1 year of follow-up. We calculated weighted mean differences (WMD) for range of motion and standardized mean differences (SMD) for shoulder scores. Postoperative complications were evaluated qualitatively. RESULTS: Fifteen studies met inclusion criteria, including 377 patients treated with RSA and 504 patients treated with hemiarthroplasty. In controlled studies, the RSA group had improved forward flexion (WMD, 21°;, P = .02) and functional outcome scores (SMD, 0.44; P = .005) compared with the hemiarthroplasty group but decreased external rotation (WMD, -5°; P < .0001). Postoperative complications were similar between the 2 groups. CONCLUSION: RSA results in improved forward flexion and functional outcome scores compared with hemiarthroplasty for older adults with proximal humeral fractures. Complications do not appear to be appreciably higher in the RSA group in the existing follow-up. The results of this review suggest that RSA is a reasonable alternative for treating older adults with proximal humeral fractures, but more research and longer follow-up are needed. LEVEL OF EVIDENCE: Level IV, systematic review.
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Authors | Ana Mata-Fink, Mary Meinke, Charlene Jones, Bokyung Kim, John-Erik Bell |
Journal | Journal of shoulder and elbow surgery
(J Shoulder Elbow Surg)
Vol. 22
Issue 12
Pg. 1737-48
(Dec 2013)
ISSN: 1532-6500 [Electronic] United States |
PMID | 24246529
(Publication Type: Comparative Study, Journal Article, Review, Systematic Review)
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Copyright | Copyright © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved. |
Topics |
- Aged
- Aged, 80 and over
- Arthroplasty, Replacement
(adverse effects, methods)
- Female
- Hemiarthroplasty
- Humans
- Male
- Range of Motion, Articular
- Recovery of Function
- Shoulder Fractures
(surgery)
- Shoulder Joint
(surgery)
- Treatment Outcome
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