Clinical results of revision shoulder arthroplasty for glenoid component loosening

• Published in: Journal of shoulder and elbow surgery 2007-11, Vol.16 (6), p.706-716
• Main Authors: Deutsch, Allen, MD, Abboud, Joseph A., MD, Kelly, James, MD, Mody, Milan, MD, Norris, Tom, MD, Ramsey, Matthew L., MD, Iannotti, Joseph P., MD, PhD, Williams, Gerald R., MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Arthroplasty - methods; Biological and medical sciences; Diseases of the osteoarticular system; Female; Humans; Joint Instability; Juxtaarticular diseases. Extraarticular rhumatism; Male; Medical sciences; Middle Aged; Orthopedics; Pain - etiology; Pain - surgery; Pain Measurement; Prosthesis Failure; Range of Motion, Articular; Reoperation; Retrospective Studies; Shoulder Joint - pathology; Shoulder Joint - surgery; Treatment Outcome
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2007.01.007

We retrospectively reviewed 32 patients who underwent glenoid revision surgery after total shoulder arthroplasty to compare the results of revision total shoulder arthroplasty with those of revision hemiarthroplasty and to identify factors associated with poor results after revision shoulder arthroplasty for glenoid component loosening. Results were reviewed at a mean follow-up of 4 years (range, 2-8 years). Glenoid reimplantation resulted in significant pain relief ( P < .0001), improvement in American Shoulder and Elbow Surgeons (ASES) score ( P < .02), and external rotation (24° to 44°, P < .004). Revision to a hemiarthroplasty also resulted in significant pain relief ( P < .01) and improvement in ASES score ( P < .05). For the treatment of glenoid loosening without glenohumeral instability, both reimplantation of a glenoid component and revision to a hemiarthroplasty improved function, satisfaction, and level of pain. Reimplantation of a new glenoid component offered greater improvements in pain ( P < .008) and external rotation (increase of 20° versus 3°, P < .03) compared with hemiarthroplasty. For patients with preoperative glenohumeral instability, revision surgery did not improve motion, function, or pain significantly. Risk factors associated with a poor outcome after revision arthroplasty included persistent glenohumeral instability, rotator cuff tears, and malunion of the greater tuberosity.