Outcomes and complications of revision reverse shoulder arthroplasty following failed primary reverse shoulder arthroplasty: a systematic review

Background: The purpose of this study is to systematically review the evidence in the literature to assess the functional outcomes, satisfaction scores, range of motion (ROM), and complication and reoperation rates following revision reverse shoulder arthroplasty (RSA) for a failed primary RSA. Methods: Two independent reviewers performed the literature search based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, utilizing the EMBASE, MEDLINE, and the Cochrane Library databases. Studies were included if they reported clinical outcomes for revision RSA for a failed primary RSA. Results: Our review found 9 studies including 211 shoulders meeting our inclusion criteria. Most patients were male (56.3%), with a mean age of 69.5 years and a mean follow-up of 44.3 months. The two most common functional outcome scores were American Shoulder and Elbow Surgeons and Simple Shoulder Test, which improved from 40.4 to 63.2 and 3.4 to 6.2, respectively. Revision RSA had a high satisfaction rate of 89.2%. ROM results include forward flexion, abduction, and external rotation that improved from 62° to 118°, 51° to 103°, and 12° to 26°, respectively. The overall complication rate and additional reoperation rate were 34.3% and 28.6%, respectively, with instability/dislocation the most common complication for both index and revision RSA. Conclusion: Revision RSA for a failed primary RSA has been shown to result in satisfactory functional outcomes and improved ROM. Most studies report high patient satisfaction rates in patients that did not have significant complications and/or required reoperations, with instability/dislocation and glenoid loosening complications the areas of the highest concern.

Duke Scholars

Author Christopher Scott Klifto Orthopaedic Surgery

Author Oke Adrian Anakwenze Orthopaedic Surgery

Author Christian Pean Orthopaedic Surgery