Revision of failed hemiarthroplasty and anatomic total shoulder arthroplasty to reverse total shoulder arthroplasty

• Published in: Journal of shoulder and elbow surgery 2019-06, Vol.28 (6), p.1074-1081
• Main Authors: Sheth, Mihir M., Sholder, Daniel, Getz, Charles L., Williams, Gerald R., Namdari, Surena
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anatomic total shoulder arthroplasty; Arthroplasty, Replacement, Shoulder - adverse effects; Female; hemiarthroplasty; Hemiarthroplasty - adverse effects; Humans; Male; Middle Aged; Pain, Postoperative; Patient Satisfaction; Range of Motion, Articular; Reoperation; reverse total shoulder arthroplasty; revision arthroplasty; shoulder complications; Texas; Treatment Failure; Treatment Outcome
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2018.10.026

The impending burden of revision shoulder arthroplasty has increased interest in outcomes of revision procedures. Revision of failed anatomic arthroplasty to reverse total shoulder arthroplasty has shown promise alongside concerning complication rates. Patients who underwent revision shoulder arthroplasty during a 7-year period at a tertiary care health system were identified. Presurgical and operative data were analyzed for 110 patients who met inclusion and exclusion criteria. Patients were contacted at a mean follow-up of 57 ± 26 months (range, 23-113 months) from revision surgery for functional outcomes scores, reoperations, and implant survival. Implant survival was 92% at 2 years and 74% at 5 years. Mean American Shoulder and Elbow Surgeons score, Single Assessment Numerical Evaluation score, and visual analog scale pain scores were 63 ± 24 (range, 5-97), 60 ± 25 (range, 0-100), and 2.9 ± 2.9 (range, 0-10), respectively. Seventy percent of patients were “very satisfied” or “satisfied with their outcome. Complications occurred in 18 patients (20%), and 10 patients (11%) underwent reoperation. Modest patient results and satisfaction can be achieved with revision of a failed anatomic arthroplasty to a reverse total shoulder arthroplasty. As is typical of revision surgery, complications are common and can compromise results. Further study is needed to identify factors that may contribute to successful outcomes.