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Reverse Total Shoulder Arthroplasty
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Revision shoulder arthroplasty for failed surface replacement hemiarthroplasty.

A Jaiswal1, A Malhotra2, S Hay2

  • 1Upper Limb Unit, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK. anujdr@gmail.com.

Musculoskeletal Surgery
|May 11, 2018
PubMed
Summary

Revision surgery for failed shoulder surface replacement hemiarthroplasty (SRH) is challenging. Glenoid erosion is the main failure cause, but outcomes improve with revision to anatomic total shoulder arthroplasty (TSA).

Keywords:
RevisionShoulder resurfacingSurface replacement hemiarthroplasty

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Musculoskeletal research

Background:

  • Shoulder surface replacement hemiarthroplasty (SRH) is a treatment option for shoulder joint issues.
  • Failures of SRH can necessitate complex revision procedures.
  • Understanding SRH failure modes is crucial for improving surgical outcomes.

Purpose of the Study:

  • To identify the primary reasons for shoulder surface replacement hemiarthroplasty (SRH) failure.
  • To assess the functional outcomes following revision surgery for failed SRHs.

Main Methods:

  • A cohort of 25 patients (26 shoulders) with failed SRHs underwent revision surgery.
  • The average time from initial SRH to revision was 3.6 years.
  • Functional outcomes were evaluated using the adjusted Constant-Murley score at a mean follow-up of 5.2 years.

Main Results:

  • Glenoid erosion (42%) and rotator cuff failure (31%) were the most frequent causes of SRH failure.
  • The median adjusted Constant-Murley score at follow-up was 51.6.
  • Patients revised to anatomic total shoulder arthroplasty (TSA) showed significantly better outcomes (median score 85) compared to other revision types (median score 36.3).

Conclusions:

  • Revision surgery for failed SRH presents technical challenges and variable results.
  • Glenoid erosion is the predominant failure mode.
  • Revising failed SRH to an anatomic TSA leads to superior functional outcomes.