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Outcomes and complications of revision reverse shoulder arthroplasty after failed primary anatomic shoulder arthroplasty or hemiarthroplasty: a systematic review.

Publication ,  Journal Article
Welch, JM; Bethell, MA; Meyer, AM; Hurley, ET; Levin, JM; Pean, CA; Anakwenze, O; Klifto, CS
Published in: J Shoulder Elbow Surg
October 2024

BACKGROUND: The purpose of this study is to systematically review the evidence in the literature to ascertain the functional outcomes, range of motion (ROM), and complication and reoperation rates after revision reverse shoulder arthroplasty (RSA) for a failed primary total shoulder arthroplasty (TSA) or hemiarthroplasty (HA). METHODS: Two independent reviewers performed the literature search based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the EMBASE, MEDLINE, and The Cochrane Library databases. Studies were included if they reported clinical outcomes for revision RSA for a failed primary TSA or HA. RESULTS: Our review found 23 studies including 1041 shoulders (627 TSA and 414 HA) meeting our inclusion criteria. The majority of patients were female (66.1%), with an average age of 69.0 years (range: 39-93 years) and a mean follow-up of 46.3 months. American Shoulder and Elbow Surgeons and visual analog scale pain scores improved from 32.6 to 61.9 and 6.7 to 2.7, respectively. ROM results include forward flexion, abduction, and external rotation, which improved from 59.4° to 107.7°, 50.7° to 104.4°, and 19.8° to 26.3°, respectively. Only 1 of the 10 studies reporting internal rotation found a statistically significant difference, with the mean internal rotation improving from S1-S3 preoperatively to L4-L5 postoperatively for patients undergoing HA. The overall complication rate and reoperation rate were 23.4% and 12.5%, respectively. The most common complications were glenoid component loosening (6.0%), fracture (periprosthetic, intraoperative, or other scapula fractures) (n = 4.7%), and infection (n = 3.3%). CONCLUSIONS: Revision RSA for a failed primary TSA and HA has been shown to result in excellent functional outcomes and improved ROM, suggesting that patients who have failed TSA or HA may benefit from a revision RSA.

Duke Scholars

Published In

J Shoulder Elbow Surg

DOI

EISSN

1532-6500

Publication Date

October 2024

Volume

33

Issue

10

Start / End Page

2306 / 2313

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Treatment Failure
  • Shoulder Joint
  • Reoperation
  • Range of Motion, Articular
  • Prosthesis Failure
  • Postoperative Complications
  • Orthopedics
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Welch, J. M., Bethell, M. A., Meyer, A. M., Hurley, E. T., Levin, J. M., Pean, C. A., … Klifto, C. S. (2024). Outcomes and complications of revision reverse shoulder arthroplasty after failed primary anatomic shoulder arthroplasty or hemiarthroplasty: a systematic review. J Shoulder Elbow Surg, 33(10), 2306–2313. https://doi.org/10.1016/j.jse.2024.03.053
Journal cover image

Published In

J Shoulder Elbow Surg

DOI

EISSN

1532-6500

Publication Date

October 2024

Volume

33

Issue

10

Start / End Page

2306 / 2313

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Treatment Failure
  • Shoulder Joint
  • Reoperation
  • Range of Motion, Articular
  • Prosthesis Failure
  • Postoperative Complications
  • Orthopedics
  • Middle Aged
  • Male