Reverse Shoulder Arthroplasty with the Increased Offset Arrow Shoulder System - Preliminary Outcome of the First Patient Series Performed in Israel

Background: Inherent disadvantages of Grammont-based reverse shoulder arthroplasty (RSA) have raised a renewed interest in less-medialised reverse shoulder designs and techniques. This study presents the preliminary outcome of the first series of patients who underwent RSA with the less-medialised Arrow reverse shoulder system (Arrow, FH Orthopedics, France) in Israel.

Methods: Ten patients (6 females, 4 males, mean age 70±8 years) with symptomatic rotator-cuff-deficient shoulders and glenohumeral arthritis underwent RSA`s with the less-medialised Arrow shoulder prosthesis and were retrospectively reviewed at a mean postoperative follow-up of 12 months.

Results: Oxford shoulder score and subjective shoulder value improved from 19±3 and 32±18 respectively before surgery to 31±18 and 61±21 after surgery (p<0.001). Pain during activity decreased from 6.2±1 to 2.5±2 (p<0.001). Active forward-elevation and external-rotation increased from 71±23 and 8±8 degrees respectively preoperatively to 109±32 and 24±8 degrees postoperatively (p<0.001). No complications occurred and radiographs at the latest follow-up showed on signs of notching or loosening.

Conclusion: The Arrow reverse shoulder provides reliable pain relief and functional improvement for patients with arthritic cuff-deficient shoulders. The preliminary short-term outcome of our patients seems comparable with other reverse shoulder implants. A longer follow-up is required to assess the implant survival and clinical performance over time.