Reverse Total Shoulder Arthroplasty: Salvage Procedure for Failed Prior Arthroplasty

Area of Science:

• Orthopedic Surgery
• Arthroplasty
• Shoulder Reconstruction

Background:

• Revision shoulder replacement is a complex procedure.
• Reverse total shoulder arthroplasty (RTSA) is an option for revision surgery.
• Evaluating clinical outcomes of revision RTSA is crucial.

Purpose of the Study:

• To assess the clinical outcomes of revision shoulder replacement using RTSA.
• To evaluate pain, range of motion, function, and patient satisfaction after revision RTSA.

Main Methods:

• Seven patients underwent revision RTSA with a mean follow-up of 22.1 months.
• Preoperative and postoperative assessments included VAS, muscle strength, range of motion, UCLA score, Constant score, and patient satisfaction.
• Indications for revision included infection, stem loosening, and glenoid arthropathy/loosening.

Main Results:

• Significant reduction in Visual Analogue Scale (VAS) pain scores (7.3 to 2.1, p=0.03).
• Improvements in active forward flexion (62.1° to 92.8°) and abduction (70° to 87.1°).
• Mean Constant score improved (44.8 to 57.1, p=0.018) and mean UCLA score improved (12.8 to 22.8, p=0.027). Five of seven patients reported satisfaction.

Conclusions:

• Revision RTSA effectively reduces pain in shoulder arthroplasty patients.
• Significant improvements in range of motion and functional scores were challenging to achieve.
• High patient satisfaction may be attributed to relief from severe preoperative pain and immobility.