The use of the reverse shoulder arthroplasty for treatment of failed total shoulder arthroplasty.

Abstract

This study evaluated the outcomes of patients with failed total shoulder arthroplasty (TSA) who were treated with conversion to reverse shoulder arthroplasty (RSA). We performed a retrospective case series of 24 consecutive patients with failed TSA who were treated with conversion to RSA. Twenty-two patients (16 women, 6 men) had a minimum 2-year clinical and radiographic follow-up. The average age at the time of revision was 68 years (range, 51-84 years). Indications for conversion to RSA included failure of TSA from glenohumeral instability in 19, mechanical failure of the humeral or glenoid component in 10, and infection in 2. The median total American Shoulder and Elbow Surgeons score improved from 38.5 preoperatively to 67.5 (P < .001). Visual analog scale pain scores decreased from 5 to 1.5 (P < .001), and function improved from 2 to 6.5 (P < .001). The median Simple Shoulder Test improved from 1 to 5 (P = .006). Forward flexion improved from 50° to 130° (P < .001), abduction from 45° to 100° (P < .001), and external rotation from 12.5° to 49.5° (P = .056). Internal rotation improved from a spinal level of S2 to L3 (P = .064). Fourteen patients rated their outcome as excellent, 3 as good, 3 as satisfactory, and 2 as unsatisfactory. The overall complication rate was 22.7% (5 of 22). RSA can be an effective treatment for failed TSA by decreasing pain and improving shoulder function. However, RSA in the revision setting is associated with a higher complication rate.