Background There remains a paucity of studies examining the conversion of failed hemiarthroplasty (HA) to reverse total shoulder arthroplasty (RTSA). Therefore, the purpose of this study was to examine a large series of revision HA to RTSA. Methods A population of 157 patients who underwent conversion of a failed HA to a revision RTSA from 2006 through 2014 were included. The mean follow-up was 49 months (range, 24-121 months). The indications for revision surgery included instability with rotator cuff insufficiency (n = 127) and glenoid wear (n = 30); instability and glenoid wear were associated in 38 cases. Eight patients with infection underwent 2-stage reimplantation. Results Patients experienced significant improvements in their preoperative to postoperative pain and shoulder range of motion (P <.0001), with median American Shoulder and Elbow Surgeons and Simple Shoulder Test scores of 60 and 6 points, respectively. There were 11 (7%) repeated revision surgeries, secondary to glenoid component loosening (n = 3), instability (n = 3), humeral component disassembly (n = 2), humeral stem loosening (n = 1), and infection (n = 2). Implant survivorship was 95.5% at 2 years and 93.3% at 5 years. There were 4 reoperations including axillary nerve neurolysis (n = 2), heterotopic ossification removal (n = 1), and hardware removal for rupture of the metal cerclage for an acromial fracture (n = 1). At final follow-up, there were 5 “at-risk” glenoid components. Conclusion Patients experience satisfactory pain relief and recovery of reasonable shoulder function after revision RTSA from a failed HA. There was a relatively low revision rate, with glenoid loosening and instability being the most common causes.

Revision of failed shoulder hemiarthroplasty to reverse total arthroplasty: analysis of 157 revision implants / Merolla, Giovanni; Wagner, Eric; Sperling, John W.; Paladini, Paolo; Fabbri, Elisabetta; Porcellini, Giuseppe. - In: JOURNAL OF SHOULDER AND ELBOW SURGERY. - ISSN 1058-2746. - 27:1(2018), pp. 75-81. [10.1016/j.jse.2017.06.038]

Revision of failed shoulder hemiarthroplasty to reverse total arthroplasty: analysis of 157 revision implants

Porcellini, Giuseppe
2018

Abstract

Background There remains a paucity of studies examining the conversion of failed hemiarthroplasty (HA) to reverse total shoulder arthroplasty (RTSA). Therefore, the purpose of this study was to examine a large series of revision HA to RTSA. Methods A population of 157 patients who underwent conversion of a failed HA to a revision RTSA from 2006 through 2014 were included. The mean follow-up was 49 months (range, 24-121 months). The indications for revision surgery included instability with rotator cuff insufficiency (n = 127) and glenoid wear (n = 30); instability and glenoid wear were associated in 38 cases. Eight patients with infection underwent 2-stage reimplantation. Results Patients experienced significant improvements in their preoperative to postoperative pain and shoulder range of motion (P <.0001), with median American Shoulder and Elbow Surgeons and Simple Shoulder Test scores of 60 and 6 points, respectively. There were 11 (7%) repeated revision surgeries, secondary to glenoid component loosening (n = 3), instability (n = 3), humeral component disassembly (n = 2), humeral stem loosening (n = 1), and infection (n = 2). Implant survivorship was 95.5% at 2 years and 93.3% at 5 years. There were 4 reoperations including axillary nerve neurolysis (n = 2), heterotopic ossification removal (n = 1), and hardware removal for rupture of the metal cerclage for an acromial fracture (n = 1). At final follow-up, there were 5 “at-risk” glenoid components. Conclusion Patients experience satisfactory pain relief and recovery of reasonable shoulder function after revision RTSA from a failed HA. There was a relatively low revision rate, with glenoid loosening and instability being the most common causes.
2018
24-lug-2017
27
1
75
81
Revision of failed shoulder hemiarthroplasty to reverse total arthroplasty: analysis of 157 revision implants / Merolla, Giovanni; Wagner, Eric; Sperling, John W.; Paladini, Paolo; Fabbri, Elisabetta; Porcellini, Giuseppe. - In: JOURNAL OF SHOULDER AND ELBOW SURGERY. - ISSN 1058-2746. - 27:1(2018), pp. 75-81. [10.1016/j.jse.2017.06.038]
Merolla, Giovanni; Wagner, Eric; Sperling, John W.; Paladini, Paolo; Fabbri, Elisabetta; Porcellini, Giuseppe
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1160340
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