- Email: [email protected]
Regarding “Reverse total shoulder arthroplasty for acute proximal humeral fracture: comparison to open reduction-internal fixation and hemiarthroplasty”
J Shoulder Elbow Surg (2014) 23, e221
www.elsevier.com/locate/ymse
CORRESPONDENCE Regarding ‘‘Reverse total shoulder arthroplasty for acute proximal humeral fracture: comparison to open reduction-internal fixation and hemiarthroplasty’’ To the Editor: We commend Chalmers et al1 on their attempt to compare 3 treatment modalities for managing proximal humeral fractures. We believe this important work will instigate further research into the subject, possibly leading to a change in the treatment of such patients. On analyzing the study design, we felt it was appropriate that adequate inclusion/exclusion criteria were adhered to as well as ensuring treatments were delivered using the same surgeon, surgical technique, and implants. Furthermore, analysis of relevant outcome measures was undertaken. Given the small numbers, do the authors support the statement that there is not enough evidence to support reverse total shoulder arthroplasty as a better treatment modality, especially as one of the patients in this subgroup required 14 months to achieve their expected functional outcomes? A matter not addressed was the differences in follow-up times and, more importantly, rehabilitation protocols, which was likely to contribute significantly and cause bias to the cost and functional analyses when comparing the 3 treatments.
Because patients who received a reverse total shoulder arthroplasty did not receive formal physical therapy and thus, presumably, there was no cost, do the authors agree it would have been more appropriate to compare each treatment equally, either physical therapy for all or none? Mohammed Shoaib Arshad, MBChB, MRCSEd Kevin R. Sharpe, FRCS (T&O) Royal Blackburn Hospital Blackburn, Lancashire, UK E-mail: [email protected]
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.
Reference 1. Chalmers PN, Slikker W 3rd, Mall NA, Gupta AK, Rahman Z, Enriquez D, Nicholson GP. Reverse total shoulder arthroplasty for acute proximal humeral fracture: comparison to open reduction-internal fixation and hemiarthroplasty. J Shoulder Elbow Surg 2014;23:197-204. http://dx.doi.org/10.1016/j.jse.2013.07.044
1058-2746/$ - see front matter Ó 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. http://dx.doi.org/10.1016/j.jse.2014.05.018
www.elsevier.com/locate/ymse
CORRESPONDENCE Regarding ‘‘Reverse total shoulder arthroplasty for acute proximal humeral fracture: comparison to open reduction-internal fixation and hemiarthroplasty’’ To the Editor: We commend Chalmers et al1 on their attempt to compare 3 treatment modalities for managing proximal humeral fractures. We believe this important work will instigate further research into the subject, possibly leading to a change in the treatment of such patients. On analyzing the study design, we felt it was appropriate that adequate inclusion/exclusion criteria were adhered to as well as ensuring treatments were delivered using the same surgeon, surgical technique, and implants. Furthermore, analysis of relevant outcome measures was undertaken. Given the small numbers, do the authors support the statement that there is not enough evidence to support reverse total shoulder arthroplasty as a better treatment modality, especially as one of the patients in this subgroup required 14 months to achieve their expected functional outcomes? A matter not addressed was the differences in follow-up times and, more importantly, rehabilitation protocols, which was likely to contribute significantly and cause bias to the cost and functional analyses when comparing the 3 treatments.
Because patients who received a reverse total shoulder arthroplasty did not receive formal physical therapy and thus, presumably, there was no cost, do the authors agree it would have been more appropriate to compare each treatment equally, either physical therapy for all or none? Mohammed Shoaib Arshad, MBChB, MRCSEd Kevin R. Sharpe, FRCS (T&O) Royal Blackburn Hospital Blackburn, Lancashire, UK E-mail: [email protected]
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.
Reference 1. Chalmers PN, Slikker W 3rd, Mall NA, Gupta AK, Rahman Z, Enriquez D, Nicholson GP. Reverse total shoulder arthroplasty for acute proximal humeral fracture: comparison to open reduction-internal fixation and hemiarthroplasty. J Shoulder Elbow Surg 2014;23:197-204. http://dx.doi.org/10.1016/j.jse.2013.07.044
1058-2746/$ - see front matter Ó 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. http://dx.doi.org/10.1016/j.jse.2014.05.018