Reverse total shoulder arthroplasty after failed deltoid flap reconstruction.

Hypothesis: Reverse shoulder arthroplasty (RSA) yields unsatisfactory results after deltoid flap reconstruction due to defect of the deltoid muscle.

Methods: We retrospectively reviewed the outcome of 19 patients after failed deltoid flap reconstruction treated with RSA. Follow-up was after a mean of 4.5 years.

Results: Seven patients (37 %) had nine postoperative complications requiring totally 16 revision surgeries. Nonetheless, at latest follow-up, 17 patients had no or mild, two had moderate, and none had severe pain. Before RSA; 13 patients had a pseudoparesis. At latest follow-up, none of the patients had a pseudoparesis. Mean flexion was 121° (90°-160°). Abduction strength averaged 2.3 kg (range 0-5.4 kg). The mean constant score was 70 % (range 28-98 %). Of the 19 patients, 15 were very satisfied with the outcome, four were satisfied, and none was dissatisfied. The mean overall subjective shoulder value was 73 % (30-95 %) of the value of a normal shoulder.

Conclusions: Despite of a localized defect of the deltoid muscle after deltoid flap repair, RSA can reliably be associated with a satisfactory outcome.