Is Reverse Shoulder Arthroplasty a Reasonable Alternative for Revision Arthroplasty?

Austin, Luke; Zmistowski, Benjamin; Chang, Edward S.; Williams, Gerald R.

doi:10.1007/s11999-010-1685-x

Cited by 78 publications

(41 citation statements)

References 10 publications

(21 reference statements)

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“…Indications for RTSA include degenerative arthritis associated with irreparable cuff tears (cuff tear arthropathy) and irreparable cuff tears with loss of function in the elderly (pseudoparalytic shoulder) [3][4][5][6][7][8][9], aseptic necrosis of the humeral head in the elderly [1], shoulder reconstruction in rheumatoid arthritis [5,10], chronic shoulder dislocations in the elderly [11], reconstruction surgery for tumour [12,13], revision surgery after failed anatomical or resurfacing arthroplasty [14][15][16][17][18][19], failed rotator cuff repair with superior escape and reconstruction for comminuted fractures of the proximal humerus in the elderly [20,21]. Any procedure addressing shoulder reconstruction with RTSA demands the existence of a functional deltoid muscle that makes shoulder mobility possible with this type of implant [20].…”

Section: Indicationsmentioning

confidence: 99%

Complications with reverse total shoulder arthroplasty and recent evolutions

Scarlat¹

2013

International Orthopaedics (SICOT)

118

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Since its description by Paul Grammont from Dijon, France, several tens of thousands of reverse total shoulder arthroplasties (RTSA) have been performed for diverse conditions. The purpose of this analysis is to identify the complications of this procedure in the literature and in clinical practice. A total of 240 papers concerning RTSA published between 1996 and 2012 have been identified. Over 80 papers describe complications associated with this type of implant. A list of prostheses satisfying European and US standards, CE and FDA approved, has been produced on the basis of information provided by the manufacturers. Data from the literature do not support a meta-analysis. The inventory of best practices shows excellent results in the short and medium term in specific indications, while the number of complications varies between 10 and 65 % in long-term series. Complications can be classified into (A) non-specific including infections (superficial and deep), phlebitis, haematoma, neurological complications of the suprascapular, radial and axillary nerves and (B) specific complications associated with RTSA including (1) on the glenoid side: intraoperative fracture of the glenoid and acromion, late fracture of the scapula, impingement at the scapular neck (notching), glenoid loosening, dissociation of the glenoid component (snatching of the glenosphere) and fractures of the glenoid baseplate; (2) on the humeral side: metaphyseal deterioration, humeral loosening, instability of the shoulder, stiffness with limitation of external and/or internal rotation; and (3) muscular complications with fatty degeneration of the deltoid. Additionally we have identified specific situations related to the type of implant such as the disassembly of the humeral or the glenoid component, dissociation of the polyethylene humeral plate, dissociation of the metaphysis and osteolysis of the tuberosities. The integration of results from different clinical series is difficult because of the lack of a database and the multitude of implants used.

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Section: Indicationsmentioning

confidence: 99%

Complications with reverse total shoulder arthroplasty and recent evolutions

Scarlat¹

2013

International Orthopaedics (SICOT)

118

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“…Whereas Wall et al have shown that the risk of instability is higher in revision surgery vs primary cases, others have shown no difference with low rates for both primary and revision procedures. 1,25,27 The surgical approach has also been shown to affect implant stability, with lower dislocation rates for the anterosuperior approach compared with the deltopectoral approach. 20 Management of the subscapularis has also had mixed results, with some authors showing lower rates of instability with subscapularis repair and others showing no difference.…”

mentioning

confidence: 99%

Results of closed management of acute dislocation after reverse shoulder arthroplasty

Teusink

Pappou

Schwartz

et al. 2015

Journal of Shoulder and Elbow Surgery

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“…5,17,22,[71][72][73][74][75][76] Revision was performed for failed treatment of proximal humeral fractures in patients with severe pain and loss of function. All patients treated in this way also had one or more of the following: tuberosity reabsorption, radiolucency around the humeral stem, osteoarthritis of the glenoid or a rotator cuff tear of > 2 cm.…”

Section: Revision Surgerymentioning

confidence: 99%

“…One retrospective study compared 28 revisions for all types of failed arthroplasty with 28 age-and gendermatched primary RSRs and showed significantly lower functional scores and ranges of movement in the revision group compared with the primary group and double the early complication rate at a minimum follow-up of one month. 75 The indication for a revision is key to deciding on the correct implant. It is well-documented that revision from a hemiarthroplasty to a total shoulder replacement for glenoid wear with an intact rotator cuff can yield good results.…”

Section: Revision Surgerymentioning

confidence: 99%

Indications for reverse shoulder replacement

Smith

Guyver

Bunker

2012

The Journal of Bone and Joint Surgery. British volume

122

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The outcome of an anatomical shoulder replacement depends on an intact rotator cuff. In 1981 Grammont designed a novel large-head reverse shoulder replacement for patients with cuff deficiency. Such has been the success of this replacement that it has led to a rapid expansion of the indications. We performed a systematic review of the literature to evaluate the functional outcome of each indication for the reverse shoulder replacement. Secondary outcome measures of range of movement, pain scores and complication rates are also presented.The modern reverse shoulder replacement (RSR) can offer a surgical option for the management of arthritis of the shoulder that would be precluded by a conventional design. 1,2The success of the prosthesis has led to expansion of the indications from cuff tear arthropathy to any disease about the shoulder where cuff function is deficient. 3-5The prosthesis has also been a financial success, leading many companies to introduce their own version with small changes to the original design, such as the Aequalis Reversed Shoulder (Tornier, SaintIsmier, France) and the SMR Shoulder (Lima, Udine, Italy). As a result of the expansion of the indications for RSR, the procedure now accounts for over a large proportion of all shoulder replacements performed in mainland Europe.This article will look at the benefits and risks of RSR for each indication. The original indication for RSR was cuff tear arthropathy. The results obtained for new indications were compared with those for cuff tear arthropathy, with a primary outcome measure as a functional score. Secondary outcome measures were range of movement, rate of complications and pain scores. In order to allow for comparison between groups, the outcome scores, complication rates and pain scores have been converted to percentages.A systematic review of the English-language literature was undertaken; the keywords used were shoulder and reverse; arthroplasty; inverse or delta. Medline, were all searched. Inclusion criteria included studies presenting new data from more than one case and where functional outcome scores were reported. Exclusion criteria included studies that had a mixture of surgical techniques presented as a single group. Further exclusion criteria for the cuff tear arthropathy group were studies published more than five years ago; studies with less than 50 patients and those from more than one centre.We identified 22 papers, which were reviewed in full. The complications of RSR for any indication were discussed and specific issues for each pathology highlighted.All the abstracts were reviewed independently by two of the authors (CDS, PG) to identify studies for full review and the bibliographies of these articles were also reviewed for additional studies. Any disagreements with regards to inclusion and exclusion were resolved by discussion with the senior author (TDB). Cuff tear arthropathyThe modern concept of cuff tear arthropathy is the combination of arthritis and a massive cuff tear where the shoulder joint may remain concent...

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Is Reverse Shoulder Arthroplasty a Reasonable Alternative for Revision Arthroplasty?

Abstract: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Cited by 78 publications

References 10 publications

Complications with reverse total shoulder arthroplasty and recent evolutions

Complications with reverse total shoulder arthroplasty and recent evolutions

Results of closed management of acute dislocation after reverse shoulder arthroplasty

Indications for reverse shoulder replacement

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