Review ArticleReverse shoulder arthroplasty for treatment of proximal humeral fractures in older adults: a systematic review
Section snippets
Review protocol
We wrote a protocol outlining a planned approach for the identification and selection of relevant studies and conducted this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.29 A log of all changes made to the protocol once the formal review was begun can be found in Appendix 1 (available on the journal's website at www.jshoulderelbow.org). The original protocol is available from the authors upon request.
Study eligibility criteria
We included
Results of search
We identified 898 unique references through our search methods. After screening titles and abstracts, we retrieved 88 references for full-text review. After a full-text review, 15 studies fulfilled our inclusion criteria after full text review (Fig 1).3, 4, 8, 14, 15, 16, 19, 20, 22, 24, 26, 33, 34, 35, 37, 38, 42
Summary of main results
RSA improves active forward flexion and functional outcome scores compared with hemiarthroplasty for older adults with proximal humeral fractures in the short-term and medium-term. Assessing the differences in complications between RSA and hemiarthroplasty was difficult due to inconsistencies in reporting complications, but the differences in number and clinical relevance of reported complications did not appear to be appreciable. No long-term data were available on function and survival of RSA.
Conclusions
The results of this systematic review suggest that RSA offers improved forward flexion and functional outcome scores compared with hemiarthroplasty in older adults with proximal humeral fractures. However, long-term follow-up studies of functional outcome and implant survival of RSA after proximal humeral fractures are necessary to make an informed decision about appropriate treatment options. This review supports the practice of treating proximal humeral fractures in older patients with
Disclaimer
The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
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Investigational Review Board approval was not required for this study.