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Reverse Total Shoulder Arthroplasty
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Instability After Reverse Total Shoulder Arthroplasty: Which Patients Dislocate?

Eric M Padegimas, Benjamin M Zmistowski, Camilo Restrepo

  • 1Division of Shoulder and Elbow Surgery, Department of Orthopedic Surgery, Rothman Institute of Orthopedics, Thomas Jefferson University Hospital, Philadelphia, PA. surena.namdari@rothmaninstitute.com.

American Journal of Orthopedics (Belle Mead, N.J.)
|December 23, 2016
PubMed
Summary

Dislocations after reverse total shoulder arthroplasty (RTSA) are uncommon but more likely in revision cases and those with higher BMI. Patients with primary cuff tear arthropathy have a low risk.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering

Background:

  • Reverse total shoulder arthroplasty (RTSA) is increasingly utilized.
  • Understanding RTSA complications, particularly dislocations, is crucial.

Purpose of the Study:

  • To investigate the incidence, predisposing factors, and treatment of dislocations following RTSA.
  • To identify risk factors for RTSA dislocation.

Main Methods:

  • Retrospective review of 510 RTSAs performed between 2010 and 2013.
  • Logistic regression analysis to identify independent risk factors for dislocation.

Main Results:

  • Fifteen dislocations occurred in 14 patients (2.9% incidence).
  • Independent risk factors included revision RTSA (OR=7.515) and higher BMI (OR=1.09).
  • Primary cuff tear arthropathy was associated with a significantly lower dislocation rate (OR=0.025).

Conclusions:

  • Dislocation after RTSA is infrequent but associated with higher BMI and revision surgery.
  • Patients undergoing RTSA for primary cuff tear arthropathy have a low risk of dislocation.
  • Management of RTSA dislocations requires operative intervention.