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Pectoralis-major-pedicled bone window for revision of a shoulder arthroplasty

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Abstract

Purpose

The aim of this study is to review our experience with the pectoralis-major-pedicled bone window for the revision of shoulder arthroplasty.

Methods

This study used the retrospective case series of six patients who underwent a pectoralis-major-pedicled bone window for revision of shoulder arthroplasty, with a minimum follow-up of 2 years. Demographic, clinical, and radiological data were analyzed.

Results

The mean age of the included patients was 72.6 years old (standard deviation (SD) 4.7), and 83.3% were women (5/1). The mean follow-up was 36.6 months (range 25–48 months). Five patients had a shoulder hemiarthroplasty and one patient a reverse shoulder arthroplasty. The indications for revision were pain in five patients and recurrent dislocation in one patient. No intraoperative complications were found. One patient developed a wound infection that required debridement and a two-stage revision. Despite complications, 2 years after surgery, the range of motions and functional scores were improved from preoperative levels. The difference between preoperative and postoperative VAS pain scores was 7.1 points (p < 0.001). The difference between preoperative and postoperative CSS and ASES questionnaires were 32 and 31.6 points, respectively (p < 0.001). At the final follow-up, all radiographs showed bone union of the osteotomy, good fixation of all components, without evidence of prosthetic loosening or migration.

Conclusions

Revision of a shoulder arthroplasty using a pectoralis-major-pedicled bone window can be an effective treatment that can yield pain relief; however, improvements in motion and function were difficult to achieve.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Shoulder and Elbow Unit. Traumatology and Orthopaedic Surgery Department, Universitat Autónoma de Barcelona, Vall d’Hebron University Hospital, Passeig de la Vall d’Hebron, 119-129, 08035, Barcelona, Spain

    Montserrat Garcia-Portabella, Jorge H. Nuñez, Lledó Batalla, Eric Montserrat, Joan Minguell & Josep Massons

  2. Traumatology and Orthopaedic Surgery Department, Universidad de Barcelona, Universitary Hospital of Mutua de Terrassa, Plaça del Doctor Robert, 5, 08221, Terrassa, Barcelona, Spain

    Jorge H. Nuñez

Authors
  1. Montserrat Garcia-Portabella
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  2. Jorge H. Nuñez
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Correspondence to Jorge H. Nuñez.

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Conflict of interest

M. Garcia-Portabella, JH. Nuñez, L. Batalla, Eric Montserrat, Joan Minguell, and J. Massons declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Garcia-Portabella, M., Nuñez, J.H., Batalla, L. et al. Pectoralis-major-pedicled bone window for revision of a shoulder arthroplasty. Eur J Orthop Surg Traumatol 33, 1275–1281 (2023). https://doi.org/10.1007/s00590-022-03292-1

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  • DOI: https://doi.org/10.1007/s00590-022-03292-1

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