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dc.contributor.authorHole, Randi Margrete
dc.contributor.authorFenstad, Anne Marie
dc.contributor.authorGjertsen, Jan-Erik
dc.contributor.authorHallan, Geir
dc.contributor.authorFurnes, Ove Nord
dc.date.accessioned2024-01-10T14:22:21Z
dc.date.available2024-01-10T14:22:21Z
dc.date.issued2023-12-15
dc.description.abstractBackground - The Delta reverse shoulder arthroplasty (RSA) is commonly used worldwide and is the most frequently used RSA in Norway. The aim of this registry-based study was to report 10- and 20-year implant survival, risk of revision, and reasons for revision in 2 consecutive time periods for Delta III (1994-2010) and Delta Xtend (2007-2021) prostheses.<p> <p>Methods - We included 3650 primary RSAs reported to the Norwegian Arthroplasty Register: 315 Delta III (42% cemented stems) and 3335 Delta Xtend (88% cemented stems). We used Kaplan-Meier analyses to investigate implant survival. The reasons for revision were compared for the 2 designs and fixation technique. Factors that could influence the risk of revision, such as implant design, fixation technique, and patient factors, were investigated using Cox regression analyses with adjustments for age, sex, and diagnosis.<p> <p>Results - Patients operated with Delta III were more likely to be diagnosed with inflammatory disease or fracture sequela, whereas acute fracture, osteoarthritis, and cuff arthropathy were the most frequent indications for Delta Xtend. Ten-year survival was 93.0% (95% confidence interval [CI]: 87.0-99.0) (cemented stem) and 81.6% (95% CI: 75.3-87.9) (uncemented stem) for Delta III and 94.7% (95% CI: 93.3-96.1) (cemented stem) and 95.7% (95% CI: 88.3-100) (uncemented stem) for Delta Xtend. Twenty-year survival for Delta III (uncemented stem) was 68.2% (95% CI: 58.8-77.6). Compared with DeltaXtend (cemented stem) at 10-year follow-up, we found a higher risk of revision for Delta III (uncemented stem) (hazard ratio [HR]: 2.9, 95% CI: 1.7-5.0), whereas no significant difference was found for Delta III (cemented stem) and Delta Xtend (uncemented stem). The most common reason for revision of Delta III (uncemented stem) was glenoid loosening followed by deep infection and instability. Instability was the most frequent revision cause for Delta Xtend (both cemented and uncemented stem). Men had an overall higher revision risk than women (HR: 2.8 [95% CI: 2.0-3.9]), and patients with fracture sequela had increased risk for revision (HR: 2.8, 95% CI: 1.7-4.7) compared with patients with osteoarthritis.<p> <p>Discussion - We found that Delta III (uncemented stem) had a higher risk of revision compared with Delta Xtend (cemented stem). The risk of revision for glenoid component loosening was lower for Delta Xtend, but revisions due to instability/dislocation are still a concern. This register study cannot determine whether the differences found were caused by differences in implant design or other factors that changed during the study period. Risk of revision may have been affected by the indication for primary operation.en_US
dc.identifier.citationHole, Fenstad, Gjertsen, Hallan, Furnes. The Delta III and Delta Xtend reverse shoulder arthroplasty. Risk of revision and failure mechanisms: a report on 3,650 cases from the Norwegian Arthroplasty Register 1994-2021. Journal of shoulder and elbow surgery. 2023en_US
dc.identifier.cristinIDFRIDAID 2199152
dc.identifier.doi10.1016/j.jse.2023.07.010
dc.identifier.issn1058-2746
dc.identifier.issn1532-6500
dc.identifier.urihttps://hdl.handle.net/10037/32407
dc.language.isoengen_US
dc.publisherElsevieren_US
dc.relation.journalJournal of shoulder and elbow surgery
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2023 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0en_US
dc.rightsAttribution 4.0 International (CC BY 4.0)en_US
dc.titleThe Delta III and Delta Xtend reverse shoulder arthroplasty. Risk of revision and failure mechanisms: a report on 3,650 cases from the Norwegian Arthroplasty Register 1994-2021en_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution 4.0 International (CC BY 4.0)
Med mindre det står noe annet, er denne innførselens lisens beskrevet som Attribution 4.0 International (CC BY 4.0)