Revision of reversed total shoulder arthroplasty. Indications and outcome

The complications of reversed total shoulder arthroplasty (RTSA) requiring an additional intervention, their treatment options and outcome are poorly known. It was therefore the purpose of this retrospective study, to identify the reasons for revision of RTSA and to report outcomes.

Four hundred and forty-one performed RTSA implanted between 1999 and 2008 were screened. Sixty-seven of these cases had an additional intervention to treat a complication. Causes were identified in these 67 cases and the outcome of the first 37 patients who could be followed for more than two years after their first additional intervention was analyzed.

Of 441 RTSA, 67 cases (15%) needed at least one additional intervention to treat a complication, 30 of them needed a second, eleven a third and four a fourth additional intervention. The most common complication requiring a first intervention was instability (18%) followed by hematoma or superficial wound complications (15%) and complications of the glenoid component (12%). Patients benefitted from RTSA despite the need of additional interventions as indicated by a mean increase in total Constant-Murley score from 23 points before RTSA to 46 points at final follow-up (p < 0.0001).

Instability, hematoma or superficial wound complications and complications of the glenoid component are the most common reasons for an additional intervention after RTSA. Patients undergoing an additional intervention as treatment of these complications profit significantly as long as the prosthesis remains in place.