Background: 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.
Methods: 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.
Results: 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.
Conclusions: 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.
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http://dx.doi.org/10.1016/j.jse.2018.10.026 | DOI Listing |
J Shoulder Elbow Surg
December 2024
Shoulder and Elbow Division, Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA.
Background: Patients undergoing reverse shoulder arthroplasty (RSA) for rotator cuff arthropathy may present with an external rotation (ER) lag due to posterior rotator cuff insufficiency. As a result, the addition of a latissimus dorsi (LD) tendon transfer in combination with RSA has become increasingly utilized. Initial descriptions of LD tendon transfer involved rerouting of the LD tendon posterior to the long head of the triceps tendon.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
December 2024
Barnet and Chase Farm Hospitals, Royal Free London NHS Foundation Trust, London, UK.
Background: The optimal treatment of 3- and 4-part proximal humeral fractures in older adults remains controversial. This aim of this study was compare patient reported outcomes following reverse shoulder arthroplasty (RSA) or non-operative management in patients over 60 years old.
Methods: A retrospective review was undertaken of patients following 3- or 4-part proximal humeral fractures treated with RSA or non-operative treatment with minimum 2-year follow-up.
Jt Dis Relat Surg
January 2025
BG Unfallklinik Tübingen, Department of Traumatology and Reconstructive Surgery, Schnarrenbergstraße 95, 72076, Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany.
Objectives: This study aimed to evaluate clinical outcome, prevalence, severity, location, range of motion, and possible risk factors of heterotopic ossification (HO) following severe radial head fractures.
Patients And Methods: In this retrospective study, 73 patients (40 males, 33 females; mean age: 51.4±15 years; range, 20 to 82 years) with Mason-Johnston type 3 and 4 radial head fractures were surgically treated with osteosynthesis or radial head arthroplasty (RHA) between September 2014 and February 2021.
J Shoulder Elbow Surg
December 2024
Department of Orthopaedics, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.
Background: Reverse total shoulder arthroplasty (RTSA) is considered a promising surgical procedure, and several studies have reported its advantages in improving shoulder elevation. However, patients undergoing RTSA may still experience challenges related to rotational movements. While external rotation may be improved with lateralization, internal rotation may occasionally deteriorate after RTSA.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
December 2024
Orthopedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, USA. Electronic address:
Background: The restriction of active internal rotation (IR) after reverse shoulder arthroplasty (RSA) poses a challenging problem for reconstructive shoulder surgeons, particularly in patients suffering from massive rotator cuff tears (mRCT) with subscapularis (SSC) deficiency. This study aims to evaluate the biomechanical effectiveness of different tendon transfer techniques following medialized glenoid and lateralized humerus RSA in improving internal rotation (IR) strength.
Methods: Eight cadaveric shoulder specimens were evaluated using a custom shoulder testing system designed to simulate loading conditions typical of mRCT with SSC insufficiency.
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