Reverse total shoulder arthroplasty after failed deltoid flap reconstruction

Area of Science:

• Orthopedic Surgery
• Musculoskeletal Research

Background:

• Deltoid muscle defects after flap reconstruction often lead to poor outcomes with reverse shoulder arthroplasty (RSA).
• Evaluating RSA's efficacy in patients with prior deltoid flap reconstruction is crucial for optimizing treatment strategies.

Purpose of the Study:

• To assess the outcomes of reverse shoulder arthroplasty (RSA) in patients who previously underwent failed deltoid flap reconstruction.
• To determine the functional recovery, complication rates, and patient satisfaction following RSA in this specific patient cohort.

Main Methods:

• Retrospective review of 19 patients who received RSA after failed deltoid flap reconstruction.
• Mean follow-up duration of 4.5 years, assessing pain, pseudoparesis, range of motion, strength, and patient-reported outcomes.

Main Results:

• 37% of patients experienced complications requiring revision surgery.
• Significant improvements were observed in pain reduction (17/19 mild/no pain) and elimination of pseudoparesis.
• Mean flexion improved to 121°, with a mean Constant score of 70% and high patient satisfaction (15/19 very satisfied).

Conclusions:

• Reverse shoulder arthroplasty (RSA) can provide satisfactory functional outcomes and patient satisfaction in cases of deltoid muscle defects following deltoid flap repair.
• Despite potential complications, RSA is a viable option for improving shoulder function in this challenging reconstructive scenario.