Long-Term Outcomes of Reverse Total Shoulder Arthroplasty

2017 ◽  
Vol 99 (6) ◽  
pp. 454-461 ◽  
Author(s):  
Guillaume Bacle ◽  
Laurent Nové-Josserand ◽  
Pascal Garaud ◽  
Gilles Walch
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Long Term Outcomes ◽  
Reverse Total Shoulder

scholarly journals Conversion to Reverse Total Shoulder Arthroplasty with and without Humeral Stem Retention: Mid-to Long-Term Results

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Marios Loucas ◽  
Rafael Loucas ◽  
Philipp Kriechling ◽  
Samy Bouaicha ◽  
Karl Wieser
Keyword(s):  
Shoulder Arthroplasty ◽  
Revision Rate ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Long Term Results ◽  
Surgical Time ◽  
Stem Revision ◽  
Stem Retention ◽  
Reverse Total Shoulder

Background: Over the past decade, conversion to Reverse Total Shoulder Arthroplasty (RTSA) has become the preferred treatment for revision of an Anatomic Hemi (HA) or Total Shoulder Arthroplasty (TSA). However, conversion of failed stemmed shoulder arthroplasty to RTSA is still a highly demanding procedure and carries unique technical challenges and risks. Questions/Purposes: This study aimed to analyze the mid- to long-term results after conversion of failed anatomical shoulder arthroplasty to RTSA and investigate whether preserving the humeral stem offers advantages over revising the humeral stem. Materials and Methods: Between 2005 and 2018, 99 hemiarthroplasties and 62 total shoulder arthroplasties (total =161 shoulders; 157 patients) were revised to RTSA without (n=47) or with (n=114) stem exchange. Complications and revisions were documented from medical and surgical records. Longitudinal pre- and post-operative clinical (Constant-Murley (CS) score, Subjective Shoulder Value (SSV)), and radiographic outcomes were assessed. Complete clinical and radiographic follow-up was available on 80% of shoulders (127 patients; 128 of 161 procedures, 46 without and 82 with stem exchange) at a minimum of 24 months and a mean of 70 months (range, 24 to 184 months). Results: Humeral stem retention was associated with a significantly reduced surgical time (193 min vs. 227 min, p=0.001, less blood loss (591 mL vs. 753 mL, p=0.037), less intraoperative complications (13% vs. 19%; Odds Ratio (OR), 1.4, p=0.32) and fewer subsequent reinterventions (19% vs. 28%; OR, 2.3, p=0.06). The complication/revision rate leading to drop out from the study was considerable in the stem revision group (ten patients; ten of 114 shoulders (9%)), but there were no complication-related dropouts in the stem-retaining group. Conclusion: Our findings suggest that humeral stem revision is associated with decreased surgical time, less blood loss, less intra- and postoperative complications, and a lower revision rate compared to humeral stem retention. Based on these findings, a shoulder arthroplasty system modularity offers substantial benefit if conversion to reverse total shoulder arthroplasty becomes necessary. Level of Evidence: Level III, therapeutic study.

Complication and revision rates after reverse total shoulder revision from hemiarthroplasty: a systematic review

2021 ◽  
pp. 175857322110193
Author(s):  
Arjun K Reddy ◽  
Jake X Checketts ◽  
B Joshua Stephens ◽  
J Michael Anderson ◽  
Craig M Cooper ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Arthroplasty ◽  
Revisional Surgery ◽  
Total Shoulder Arthroplasty ◽  
Surgical Site Infections ◽  
Total Sample ◽  
Reverse Total Shoulder Arthroplasty ◽  
Common Complication ◽  
Humeral Component ◽  
Reverse Total Shoulder

Background Thus, the purpose of the present study was to (1) characterize common postoperative complications and (2) quantify the rates of revision in patients undergoing hemiarthroplasty to reverse total shoulder arthroplasty revisional surgery. We hypothesize that hardware loosenings will be the most common complication to occur in the sample, with the humeral component being the most common loosening. Methods This systematic review adhered to PRISMA reporting guideline. For our inclusion criteria, we included any study that contained intraoperative and/or postoperative complication data, and revision rates on patients who had undergone revision reverse total shoulder arthroplasty due to a failed hemiarthroplasty. Complications include neurologic injury, deep surgical site infections, hardware loosening/prosthetic instability, and postoperative fractures (acromion, glenoid, and humeral fractures). Results The study contained 22 studies that assessed complications from shoulders that had revision reverse total shoulder arthroplasty from a hemiarthroplasty, with a total sample of 925 shoulders. We found that the most common complication to occur was hardware loosenings (5.3%), and of the hardware loosenings, humeral loosenings (3.8%) were the most common. The revision rate was found to be 10.7%. Conclusion This systematic review found that revision reverse total shoulder arthroplasty for failed hemiarthroplasty has a high overall complication and reintervention rates, specifically for hardware loosening and revision rates.

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