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Reverse shoulder arthroplasty for instability arthropathy

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Abstract

Purpose

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.

Methods

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).

Results

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.

Conclusions

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.

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Author information

Authors and Affiliations

  1. Shoulder and Elbow Service HUS – CCOM, 10, Avenue Baumann, F-67400, Illkirch, France

    Philippe Clavert & Agathe Kling

  2. Centre chirurgical Émile-Gallé, CHRU, 49, rue Hermite, 54000, Nancy, France

    François Sirveaux & Daniel Mole

  3. Hôpital Trousseau, CHRU de Tours, avenue de la République, 37170, Chambray-lès-Tours, France

    Luc Favard

  4. Ramsey Générale de Santé Hôpital Privé Jean Mermoz, Lyon, France

    Gilles Walch

  5. Department of Orthopaedic Surgery, iULS (Institut Universitaire Locomoteur & Sport), University of Nice Sophia Antipolis, Nice, France

    Pascal Boileau

Authors
  1. Philippe Clavert
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  2. Agathe Kling
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  3. François Sirveaux
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  4. Luc Favard
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  5. Daniel Mole
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  6. Gilles Walch
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  7. Pascal Boileau
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Corresponding author

Correspondence to Philippe Clavert.

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Conflict of interest

Except Agathe Kling, all authors have the same conflict of interest with Wright-Tornier.

Additional information

Level IV study: retrospective study

Level of evidence: Level IV, Case Series, Treatment Study

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Clavert, P., Kling, A., Sirveaux, F. et al. Reverse shoulder arthroplasty for instability arthropathy. International Orthopaedics (SICOT) 43, 1653–1658 (2019). https://doi.org/10.1007/s00264-018-4123-4

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  • DOI: https://doi.org/10.1007/s00264-018-4123-4

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