Effect of Complications on Outcomes After Revision Reverse Total Shoulder Arthroplasty

Overview

Journal JSES Int

Date 2020 Sep 17

PMID 32939503

Citations 12

Authors

Robert Z Tashjian

Erin Granger

Kortnie Broschinsky

Jun Kawakami

Peter N Chalmers

Affiliations

Soon will be listed here.

Abstract

Background: Revision reverse total shoulder arthroplasty (RTSA) reliably improves shoulder pain and function in patients with failed shoulder arthroplasty, although it can lead to significant postoperative complications. The purpose of this study was to determine the effect of postoperative complications on shoulder pain and function after revision RTSA.

Methods: We evaluated 36 patients at an average of 4.3 years (range, 2-8.6 years) after revision of a shoulder arthroplasty to RTSA. Of these patients, 9 had a failed anatomic total shoulder arthroplasty, 23 had a failed hemiarthroplasty, and 4 had a failed RTSA. The American Shoulder and Elbow Surgeons (ASES) score and visual analog scale (VAS) pain score were evaluated postoperatively, and patients with and without postoperative complications were compared.

Results: The final ASES score and VAS pain score were 61 ± 23 and 2.4 ± 2.3, respectively. A major postoperative complication occurred in 7 patients (19%) (infection in 3, hematoma in 1, instability in 1, and acromial and/or scapular spine fracture in 2). Further surgical treatment was required in 5 patients (14%) (irrigation and débridement and component exchange for infection in 3, irrigation and débridement for hematoma in 1, and open reduction-internal fixation of scapular spine fracture in 1). On comparison of clinical outcomes between patients with and patients without complications, the ASES score and VAS pain score were significantly worse in patients with complications vs. those without them (ASES score, 43 ± 24 vs. 66 ± 21 [ = .04]; VAS pain score, 4.3 ± 2 vs. 2 ± 2.2 [ = .03]).

Conclusion: Revision RTSA resulted in postoperative pain and shoulder function comparable to primary RTSA reported in the literature, although postoperative complications led to clinically significant declines in function and increases in pain.

Citing Articles

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Outcomes of revision versus re-revision reverse total shoulder arthroplasty: A case-control-matched cohort study.

OKeefe D, Teurlings T, Hao K, Saengchote S, Schoch B, Wright T Shoulder Elbow. 2024; 16(5):543-550.

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Reverse shoulder arthroplasty with an inverted-bearing prosthesis as revision procedure for failed anatomic and reverse shoulder arthroplasty: a long-term multicenter study.

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Walker J, Richards B, Cronin J, Skedros J Cureus. 2023; 15(8):e42865.

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