Revision of failed reverse shoulder arthroplasty to revision reverse shoulder arthroplasty leads to significant clinical and functional improvement |
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| Institution: | 1. University of Arizona College of Medicine, Phoenix, AZ, USA;2. Cleveland Shoulder Institute, Cleveland, OH, USA;3. Banner Health, Phoenix, AZ, USA;1. Florida Orthopaedic Institute, Shoulder and Elbow Service, Tampa, FL, USA;2. Foundation for Orthopaedic Research and Education, Translational Research, Tampa, FL, USA;3. University of South Florida, Department of Medical Engineering, College of Engineering & Morsani College of Medicine, Tampa, FL, USA;4. University of South Florida, Tampa, FL, USA |
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| Abstract: | BackgroundReverse shoulder arthroplasty (RSA) is rapidly growing in the United States. As the number of procedures increases, the number of complications and need for additional surgeries correspondingly continues to grow. The purpose of this study was to describe clinical and functional outcomes of revision of RSA to RSA.MethodsA retrospective review of 29 patients from 2 centers who underwent revision surgery following RSA to RSA from 2007 to 2017 was conducted. The reasons for revision were recorded. Clinical outcome measures including shoulder range of motion, American Shoulder and Elbow Surgeons score, Single Assessment Numerical Evaluation score, simple shoulder test and Visual analog scale scores were collected for all patients at an average follow-up of 29 months. Postoperative complications were also recorded.ResultsA total of 29 patients were identified. The average time between index RSA and revision was 2.3 years (30 days – 7 years). Mean follow-up duration for clinical outcome measures was 29.1 months (12-114 months). The most common indication for revision surgery was aseptic loosening (13/29, 44.8%), followed by instability (7/29, 24.1%), fracture (5/29, 17.2%), and infection (4/29, 13.7%). The average Visual analog scale decreased from 7 to 3 (P< .001). American Shoulder and Elbow Surgeons score scores improved from a mean of 30 to 58 (P < .001). Single Assessment Numerical Evaluation score scores improved from 26 to 54 (P < .001), and Simple shoulder test improved from 2 to 6 (P = .001). Range of motion in both forward elevation from 76° to 131° (P < .001) and external rotation from 26 to 42 (P = .001). Complications were seen in 10 of 29 patients (34.5%).ConclusionA failed RSA can be managed with revision RSA with acceptable clinical outcomes although outcome is inferior to primary RSA with a high rate of complications.Level of EvidenceLevel IV; Retrospective Case Series |
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