International Orthopaedics

, Volume 43, Issue 7, pp 1653–1658 | Cite as

Reverse shoulder arthroplasty for instability arthropathy

  • Philippe ClavertEmail author
  • Agathe Kling
  • François Sirveaux
  • Luc Favard
  • Daniel Mole
  • Gilles Walch
  • Pascal Boileau
Original Paper



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.


Reverse 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. 1.
    Rowe C, Sakellarides H (1961) Factors related to recurrences of anterior dislocations of the shoulder. Clin Orthop 20:40–48Google Scholar
  2. 2.
    Schandelmaier P, Blauth M, Schneider C, Krettek C (2002) Fractures of the glenoid treated by operation. A 5- to 23-year follow-up of 22 cases. J Bone Joint Surg 84(B):173–177. Google Scholar
  3. 3.
    Raiss P, Baumann F, Akbar M, Rickert M, Loew M (2009) Open screw fixation of large anterior glenoid rim fractures: mid- and long-term results in 29 patients. Knee Surg Sports Traumatol Arthrosc 17:195–203. CrossRefGoogle Scholar
  4. 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
  5. 5.
    Hovelius L, Augustini B, Fredin H, Johansson O, Norlin R, Thorling J (1996) Primary anterior dislocation of the shoulder in young patients. A ten-year prospective study. J Bone Joint Surg Am 78:1677–1684CrossRefGoogle Scholar
  6. 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. CrossRefGoogle Scholar
  7. 7.
    Wall M, Warren R (1995) Complications of shoulder instability surgery. Clin Sports Med 14:973–1000Google Scholar
  8. 8.
    Walch G (1996) Chronic anterior glenohumeral instability. J Bone Joint Surg (Br) 78:670–677CrossRefGoogle Scholar
  9. 9.
    Walch G (2000) Chronic anterior instability of the shoulder in adults. Summary. Rev Chir Orthop 86(Suppl 1):147–149Google Scholar
  10. 10.
    Hovelius L, Korner L, Lundberg B, Akermark C, Herberts P, Wredmark T, Berg E (1983) The coracoid transfer for recurrent dislocation of the shoulder. Technical aspects of the Bristow-Latarjet procedure. J Bone Joint Surg 65(A):926–934CrossRefGoogle Scholar
  11. 11.
    Hovelius L, Thorling J, Fredin H (1979) Recurrent anterior dislocation of the shoulder: results after Bankart and Putti-Platt operations. J Bone Joint Surg 61(A):566–569CrossRefGoogle Scholar
  12. 12.
    Bigliani L, Weinstein D, Glasgow M (1995) Glenohumeral arthroplasty for arthritis after instability surgery. J Shoulder Elb Surg 4:87–94CrossRefGoogle Scholar
  13. 13.
    Green A, Norris T (2001) Shoulder arthroplasty for advanced glenohumeral arthritis after anterior instability repair. J Shoulder Elb Surg 10(6):539–545CrossRefGoogle Scholar
  14. 14.
    Sperling J, Cofield R, Steinmann S (2002) Shoulder arthroplasty for osteoarthritis secondary to glenoid dysplasia. J Bone Joint Surg 84(A):541–546CrossRefGoogle Scholar
  15. 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
  16. 16.
    Lehmann L, Magosch P, Mauermann E, Lichtenberg S, Habermeyer P (2010) Total shoulder arthroplasty in dislocation arthropathy. Int Orthop 34:1219–1225. CrossRefGoogle Scholar
  17. 17.
    Werner B, Böhm D, Abdelkawi A, Gohlke F (2014) Glenoid bone grafting in reverse shoulder arthroplasty for long-standing anterior shoulder dislocation. J Shoulder Elb Surg 23:1655–1661. CrossRefGoogle Scholar
  18. 18.
    Kurowicki J, Triplet J, Momoh E, Moor M, Levy J (2016) Reverse shoulder prosthesis in the treatment of locked anterior shoulders: a comparison with classic reverse shoulder indications. J Shoulder Elb Surg 25:1954–1960. CrossRefGoogle Scholar
  19. 19.
    Flatow E, Miller S, Neer C (1993) Chronic anterior dislocation of the shoulder. J Shoulder Elb Surg 2:2–10. CrossRefGoogle Scholar
  20. 20.
    Buscayret F, Edwards T, Szabo I, Adeleine P, Coudane H, Walch G (2004) Glenohumeral arthrosis in anterior instability before and after surgical treatment: incidence and contributing factors. Am J Sports Med 32:1165–1172CrossRefGoogle Scholar
  21. 21.
    Samilson R, Prieto V (1983) Dislocation arthropathy of the shoulder. J Bone Joint Surg 65(A):456–460CrossRefGoogle Scholar
  22. 22.
    Constant C, Murley A (1987) A clinical method of functional assessment of the shoulder. Clin Orthop 214:160–164Google Scholar
  23. 23.
    Gilbart M, Gerber C (2007) Comparison of the subjective shoulder value and the constant score. J Shoulder Elb Surg 16:717–721CrossRefGoogle Scholar
  24. 24.
    Walch G, Badet R, Boulahia A, Khoury A (1999) Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplast 14:756–760CrossRefGoogle Scholar
  25. 25.
    Lévigne C, Boileau P, Favard L, Garaud P, Molé D, Sirveaux F, Walch G (2008) Scapular notching in reverse shoulder arthroplasty. J Shoulder Elb Surg 17:925–935. CrossRefGoogle Scholar
  26. 26.
    Boileau P, Moineau G, Roussanne Y, O’Shea K (2011) Bony increased-offset reversed shoulder arthroplasty: minimizing scapular impingement while maximizing glenoid fixation. Clin Orthop Relat Res 469:2558–2567. CrossRefGoogle Scholar
  27. 27.
    Hill J, Norris T (2001) Long-term results of total shoulder arthroplasty following bone-grafting of the glenoid. J Bone Joint Surg 83(Am):877–883CrossRefGoogle Scholar
  28. 28.
    Hamada K, Fukuda H, Mikasa M, Kobayashi Y (1990) Roentgenographic findings in massive rotator cuff tears. Clin Orthop 254:92–96Google Scholar
  29. 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.
  30. 30.
    Statz J, Schoch B, Sanchez-Sotelo J, Sperling J, Cofield R (2017) Shoulder arthroplasty for locked anterior shoulder dislocation: a role for the reversed design. Int Orthop 41:1227–1234. CrossRefGoogle Scholar

Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  1. 1.Shoulder and Elbow Service HUS – CCOMIllkirchFrance
  2. 2.Centre chirurgical Émile-Gallé, CHRUNancyFrance
  3. 3.Hôpital Trousseau, CHRU de ToursChambray-lès-ToursFrance
  4. 4.Ramsey Générale de Santé Hôpital Privé Jean MermozLyonFrance
  5. 5.Department of Orthopaedic Surgery, iULS (Institut Universitaire Locomoteur & Sport)University of Nice Sophia AntipolisNiceFrance

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