Evidence map›Paper›PMID 37821859›Full record

SynthesisBMC musculoskeletal disorders2023

Implant breakage after shoulder arthroplasty: a systematic review of data from worldwide arthroplasty registries and clinical trials.

Martin Liebhauser, Gloria Hohenberger, Birgit Lohberger, Georg Hauer, Amelie Deluca, Patrick Sadoghi

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in BMC musculoskeletal disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Martin LiebhauserDepartment of Traumatology, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria.
Gloria HohenbergerDepartment of Traumatology, State Hospital Feldbach, Fürstenfeld, Austria.
Birgit LohbergerDepartment of Orthopedics and Trauma, Medical University of Graz, Graz, Austria.
Georg HauerDepartment of Orthopedics and Trauma, Medical University of Graz, Graz, Austria.
Amelie DelucaDepartment of Orthopedic Surgery, SKA Warmbad Villach, Villach, Austria.
Patrick SadoghiDepartment of Orthopedics and Trauma, Medical University of Graz, Graz, Austria. patrick.sadoghi@medunigraz.at.ORCID http://orcid.org/0000-0003-1767-555X
Medical University of Graz · ATKlinikum Klagenfurt · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImplant breakage after shoulder arthroplasty is a rare complication after aseptic loosening, infection or persistent pain, resulting in malfunction of the components requiring revision surgery. This correlates with a high burden for the patient and increasing costs. Specific data of complication rates and implant breakage are available in detailed arthroplasty registries, but due to the rare occurrence and possibly underestimated value rarely described in published studies. The aim of this systematic review was to point out the frequency of implant breakage after shoulder arthroplasty. We hypothesized that worldwide arthroplasty registry datasets record higher rates of implant breakage than clinical trials.

methodsPubMed, MEDLINE, EMBASE, CINHAL, and the Cochrane Central Register of Controlled Trials database were utilized for this systematic review using the items "(implant fracture/complication/breakage) OR (glenoid/baseplate complication/breakage) AND (shoulder arthroplasty)" according to the PRISMA guidelines on July 3rd, 2023. Study selection, quality assessment, and data extraction were conducted according to the Cochrane standards. Case reports and experimental studies were excluded to reduce bias. The breakage rate per 100,000 observed component years was used to compare data from national arthroplasty registries and clinical trials, published in peer-reviewed journals. Relevant types of shoulder prosthetics were analyzed and differences in implant breakage were considered.

resultsData of 5 registries and 15 studies were included. Rates of implant breakage after shoulder arthroplasty were reported with 0.06-0.86% in registries versus 0.01-6.65% in clinical studies. The breakage rate per 100,000 observed component years was 10 in clinical studies and 9 in registries. There was a revision rate of 0.09% for registry data and 0.1% for clinical studies within a 10-year period. The most frequently affected component in connection with implant fracture was the glenoid insert.

conclusionClinical studies revealed a similar incidence of implant failure compared to data of worldwide arthroplasty registries. These complications arise mainly due to breakage of screws and glenospheres and there seems to be a direct correlation to loosening. Periprosthetic joint infection might be associated with loosening of the prosthesis and subsequent material breakage. We believe that this analysis can help physicians to advise patients on potential risks after shoulder arthroplasty. LEVEL OF EVIDENCE: III.

Indexed as

Arthroplasty, Replacement, ShoulderShoulder JointShoulder ProsthesisHumansPostoperative ComplicationsProsthesis FailureProsthesis ImplantationRegistriesReoperationTreatment OutcomeImplant breakageImplant fractureReversed shoulder arthroplastyShoulder arthroplastyTotal shoulder arthroplasty

Identifiers

PMID37821859
PMCPMC10565962
OpenAlexW4387531577

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.