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

Abstract

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.

Clinical and functional outcomes of reverse total shoulder arthroplasty supplemented with latissimus dorsi transfer: a systematic review and meta-analysis

“… 16 The revision rate for our sample was even higher than the revision rate of 10.7% for converting hemiarthroplasty to RTSAs. 19 Furthermore, the incidence of postoperative fracture in the included studies was 4.23%, which is higher than the 2.5% reported in the literature for traditional RTSAs. 16 It is our postulation that the increased complications stem from the excess soft-tissue stripping/transfer of the latissimus, which likely results in more violation of tissues and possibly periosteum about the shoulder.…”

“…This search string is a published and validated sensitive search string for obtaining rTSA literature. 19 …”

Proximal humerus reconstruction in reverse total shoulder arthroplasty with proximal humeral bone loss using a lower trapezius tendon transfer with Achilles tendon-bone allograft: surgical technique and report of 2 cases

“…The manifestations and the relevance of PHBL in RTSA 2 , 12 , 13 , 32 have previously been discussed by several authors, mostly in the context of fracture sequelae and revision arthroplasty. In summary, the literature states, that clinical outcome is highly dependent on the integrity of the greater tuberosity and that loss of humeral bone stock attributes to complications, particularly loss of ER function and instability.…”

“…In summary, the literature states, that clinical outcome is highly dependent on the integrity of the greater tuberosity and that loss of humeral bone stock attributes to complications, particularly loss of ER function and instability. 5 , 2 , 10 , 20 , 32 According to Boileau et al, 5 61% of fracture RTSA patients with loss of the greater tuberosity have an ER lag. In 2014, Greiner et al 20 published that the extent of the metaphyseal bone defect of the lateral cortex is significantly correlated with poor postoperative outcome.…”

The Use of a Distal Radius Allograft for Severe Glenoid Bone Loss in the Setting of Revision Shoulder Arthroplasty

“…n the setting of revision shoulder arthroplasty, instability and recurrent dislocations can be caused by deformities in glenoid morphology, such as glenoid retroversion and severe glenoid bone loss [1][2][3][4] . In these cases, the bony foundation required for fixating the prosthetic components is compromised, and as such, this entails a variety of surgical challenges and difficulties and often necessitates revision surgeries that can help augment the foundation of the compromised arthroplasty [1][2][3][4] . Traditionally, this can be conducted using a structural bone graft introduced to the patient's glenoid 5 .…”