Reverse shoulder arthroplasty for instability arthropathy
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Osteoarthritis may be observed after surgery for instability and in the natural history of pathology. The primary objective was to analyze the late clinical and radiographic results of reverse shoulder arthroplasties (RSA) for patients who had instability arthropathy.
This is a retrospective cohort of 25 patients with a mean follow-up of 6.6 years. Patients had a history of instability surgery (80%) or multiple closed reductions. All were clinically evaluated with the constant score (CS), and radiologically (true AP view and Y view).
No significant differences in pre- and post-operative function, radiologic status, and complication rate between the patients treated with a prior bone block procedure for the anterior instability and those treated by a capsular plication or non-operatively. A 36-mm sphere was implanted in 67%. Bone grafting of the glenoid was needed in 71%. No intra-operative complication has been reported. Clinically, the active anterior elevation increased from 70° to 140° (p < 0.01) and external rotation from 9° to 21° (p = 0.02). The adjusted CS increased from 38 to 98 (p < 0.01). Two early post-operative complications were collected: one spine fracture and one superficial infection. No early or late dislocation or neurologic complication was observed. At the latest follow-up, there were 38.10% of glenoid spurs, and 55% of scapular notch.
The overall complication rate in this specific group is relatively low. Patients’ satisfaction rate is high and clearly higher than those reported with anatomic TSA for this indication. Clinical results are comparable to other studies describing results of RSA.
KeywordsReverse shoulder Anterior instability Shoulder dislocation Glenoid bone loss Glenoid bone grafting Complication
Compliance with ethical standards
Conflict of interest
Except Agathe Kling, all authors have the same conflict of interest with Wright-Tornier.
- 1.Rowe C, Sakellarides H (1961) Factors related to recurrences of anterior dislocations of the shoulder. Clin Orthop 20:40–48Google Scholar
- 4.Hovelius L (1987) Anterior dislocation of the shoulder in teen-agers and young adults: five-year prognosis. J Bone Joint Surg 69(A):393–399Google Scholar
- 6.Neyton L, Young A, Dawidziak B, Visona E, Hager J, Fournier Y, Walch G (2012) Surgical treatment of anterior instability in rugby union players: clinical and radiographic results of the Latarjet-Patte procedure with minimum 5-year follow-up. J Shoulder Elb Surg 21:1721–1727. https://doi.org/10.1016/j.jse.2012.01.023 CrossRefGoogle Scholar
- 7.Wall M, Warren R (1995) Complications of shoulder instability surgery. Clin Sports Med 14:973–1000Google Scholar
- 9.Walch G (2000) Chronic anterior instability of the shoulder in adults. Summary. Rev Chir Orthop 86(Suppl 1):147–149Google Scholar
- 15.Matsoukis J, Tabib W, Mandelbaum A, Walch G (2003) Shoulder arthroplasty for non-operated anterior shoulder instability with secondary osteoarthritis. Rev Chir Orthop 89:7–18Google Scholar
- 22.Constant C, Murley A (1987) A clinical method of functional assessment of the shoulder. Clin Orthop 214:160–164Google Scholar
- 28.Hamada K, Fukuda H, Mikasa M, Kobayashi Y (1990) Roentgenographic findings in massive rotator cuff tears. Clin Orthop 254:92–96Google Scholar
- 29.Merolla G, Cerciello S, Marenco S, Fabbri E, Paladini P, Porcellini G (2018) Comparison of shoulder replacement to treat osteoarthritis secondary to instability surgery and primary osteoarthritis: a retrospective controlled study of patient outcomes. Int Orthop 12. https://doi.org/10.1007/s00264-018-3969-9