Skip to main content

Advertisement

Log in

Is reverse total shoulder arthroplasty a feasible treatment option for failed shoulder arthroplasty? A retrospective study of 44 cases with special regards to stemless and stemmed primary implants

  • Original Article
  • Published:
MUSCULOSKELETAL SURGERY Aims and scope Submit manuscript

Abstract

Is reverse total shoulder arthroplasty a feasible treatment option for failed shoulder arthroplasty? A retrospective study of 44 cases with special regards to stemless and stemmed primary implants.

Background

Due to humeral or glenoid bone-loss and rotator cuff insufficiency reverse total shoulder arthroplasty often means the only remaining treatment option in revision shoulder arthroplasty. This study investigates the clinical outcome of patients treated with a reverse total shoulder in revision cases with special regard to stemless and stemmed primary implants.

Materials and methods

From 2010 to 2012 60 failed shoulder arthroplasties were converted to reverse total shoulder arthroplasty. Forty-four patients were available for follow-up after a mean of 24 months. Patients were assessed with X-rays, Constant- and ASES Score and a questionnaire about their subjective satisfaction.

Results

The total number of observed complications was seven (16%). Ninety-eight percent of the patients were satisfied with their clinical result. Patients achieved a mean normalized constant score of 70.2% and a mean ASES Score of 65.3. Patients with stemless primary implants achieved a higher normalized constant score than patients with stemmed primary implants (82 vs. 61.8%; p = 0009).

Conclusion

Reverse total shoulder arthroplasty provides satisfactory clinical results and a high patient satisfaction in revision shoulder arthroplasty. The complication rate needs to be considered and discussed with the patient prior to surgery. Presence or absence of a stem of revised shoulder arthroplasties interferes with the outcome.

Level of evidence IV

(Retrospective study).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Dines JS, Fealy S, Strauss EJ, Allen A, Craig EV, Warren RF, Dines DM (2006) Outcomes analysis of revision total shoulder replacement. J Bone Joint Surg Am 88:1494–1500. doi:10.2106/JBJS.D.02946

    PubMed  Google Scholar 

  2. Franklin JL, Barrett WP, Jackins SE, Matsen FA 3rd (1988) Glenoid loosening in total shoulder arthroplasty. Association with rotator cuff deficiency. J Arthroplasty 3:39–46

    Article  CAS  PubMed  Google Scholar 

  3. Ortmaier R, Resch H, Matis N, Blocher M, Auffarth A, Mayer M, Hitzl W, Tauber M (2013) Reverse shoulder arthroplasty in revision of failed shoulder arthroplasty-outcome and follow-up. Int Orthop 37:67–75. doi:10.1007/s00264-012-1742-z

    Article  PubMed  Google Scholar 

  4. Habermeyer P, Magosch P (2013) Strategies in revision shoulder arthroplasty. Orthopade 42:542–551. doi:10.1007/s00132-012-2025-5

    Article  CAS  PubMed  Google Scholar 

  5. Gonzalez JF, Alami GB, Baque F, Walch G, Boileau P (2011) Complications of unconstrained shoulder prostheses. J Shoulder Elbow Surg 20:666–682. doi:10.1016/j.jse.2010.11.017

    Article  PubMed  Google Scholar 

  6. Zumstein MA, Pinedo M, Old J, Boileau P (2011) Problems, complications, reoperations, and revisions in reverse total shoulder arthroplasty: a systematic review. J Shoulder Elbow Surg 20:146–157. doi:10.1016/j.jse.2010.08.001

    Article  PubMed  Google Scholar 

  7. Austin L, Zmistowski B, Chang ES, Williams GR Jr (2011) Is reverse shoulder arthroplasty a reasonable alternative for revision arthroplasty? Clin Orthop Relat Res 469:2531–2537. doi:10.1007/s11999-010-1685-x

    Article  PubMed  Google Scholar 

  8. Boileau P, Watkinson D, Hatzidakis AM, Hovorka I (2006) Neer Award 2005: the Grammont reverse shoulder prosthesis: results in cuff tear arthritis, fracture sequelae, and revision arthroplasty. J Shoulder Elbow Surg 15:527–540. doi:10.1016/j.jse.2006.01.003

    Article  PubMed  Google Scholar 

  9. Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Mole D (2004) Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Joint Surg Br 86:388–395

    Article  CAS  PubMed  Google Scholar 

  10. Wall B, Nove-Josserand L, O’Connor DP, Edwards TB, Walch G (2007) Reverse total shoulder arthroplasty: a review of results according to etiology. J Bone Joint Surg Am 89:1476–1485. doi:10.2106/JBJS.F.00666

    PubMed  Google Scholar 

  11. Walch G, Bacle G, Ladermann A, Nove-Josserand L, Smithers CJ (2012) Do the indications, results, and complications of reverse shoulder arthroplasty change with surgeon’s experience? J Shoulder Elbow Surg 21:1470–1477. doi:10.1016/j.jse.2011.11.010

    Article  PubMed  Google Scholar 

  12. Kelly JD 2nd, Zhao JX, Hobgood ER, Norris TR (2012) Clinical results of revision shoulder arthroplasty using the reverse prosthesis. J Shoulder Elbow Surg 21:1516–1525. doi:10.1016/j.jse.2011.11.021

    Article  PubMed  Google Scholar 

  13. Patel DN, Young B, Onyekwelu I, Zuckerman JD, Kwon YW (2012) Reverse total shoulder arthroplasty for failed shoulder arthroplasty. J Shoulder Elbow Surg 21:1478–1483. doi:10.1016/j.jse.2011.11.004

    Article  PubMed  Google Scholar 

  14. Maynou C, Menager S, Senneville E, Bocquet D, Mestdagh H (2006) Clinical results of resection arthroplasty for infected shoulder arthroplasty. Rev Chir Orthop Reparatrice Appar Mot 92:567–574

    Article  CAS  PubMed  Google Scholar 

  15. Muh SJ, Streit JJ, Lenarz CJ, McCrum C, Wanner JP, Shishani Y, Moraga C, Nowinski RJ, Edwards TB, Warner JJ, Walch G, Gobezie R (2013) Resection arthroplasty for failed shoulder arthroplasty. J Shoulder Elbow Surg 22:247–252. doi:10.1016/j.jse.2012.05.025

    Article  PubMed  Google Scholar 

  16. Rispoli DM, Sperling JW, Athwal GS, Schleck CD, Cofield RH (2007) Pain relief and functional results after resection arthroplasty of the shoulder. J Bone Joint Surg Br 89:1184–1187. doi:10.1302/0301-620X.89B9.19464

    Article  CAS  PubMed  Google Scholar 

  17. Ruhmann O, Schmolke S, Bohnsack M, Flamme C, Wirth CJ (2005) Shoulder arthrodesis: indications, technique, results, and complications. J Shoulder Elbow Surg 14:38–50. doi:10.1016/j.jse.2004.05.008

    Article  PubMed  Google Scholar 

  18. Scalise JJ, Iannotti JP (2009) Glenohumeral arthrodesis after failed prosthetic shoulder arthroplasty Surgical technique. J Bone Joint Surg Am 91(Suppl 2 Pt 1):30–37. doi:10.2106/JBJS.H.01249

    Article  PubMed  Google Scholar 

  19. Maier MW, Lauer S, Klotz MC, Bulhoff M, Spranz D, Zeifang F (2015) Are there differences between stemless and conventional stemmed shoulder prostheses in the treatment of glenohumeral osteoarthritis? BMC Musculoskelet Disord 16:275. doi:10.1186/s12891-015-0723-y

    Article  PubMed  PubMed Central  Google Scholar 

  20. Churchill RS (2014) Stemless shoulder arthroplasty: current status. J Shoulder Elbow Surg 23:1409–1414. doi:10.1016/j.jse.2014.05.005

    Article  PubMed  Google Scholar 

  21. Mariotti U, Motta P, Stucchi A, Ponti di Sant’Angelo F (2014) Stemmed versus stemless total shoulder arthroplasty: a preliminary report and short-term results. Musculoskelet Surg 98:195–200. doi:10.1007/s12306-014-0312-5

    Article  CAS  PubMed  Google Scholar 

  22. Thomas M, Dieball O, Busse M (2003) Normal values of the shoulder strength in dependency on age and gender—comparison with the constant, UCLA, ASES scores and SF36 health survey. Z Orthop Ihre Grenzgeb 141:160–170. doi:10.1055/s-2003-38662

    Article  CAS  PubMed  Google Scholar 

  23. Levy J, Frankle M, Mighell M, Pupello D (2007) The use of the reverse shoulder prosthesis for the treatment of failed hemiarthroplasty for proximal humeral fracture. J Bone Joint Surg Am 89:292–300. doi:10.2106/JBJS.E.01310

    PubMed  Google Scholar 

  24. Levy JC, Virani N, Pupello D, Frankle M (2007) Use of the reverse shoulder prosthesis for the treatment of failed hemiarthroplasty in patients with glenohumeral arthritis and rotator cuff deficiency. J Bone Joint Surg Br 89:189–195. doi:10.1302/0301-620X.89B2.18161

    Article  CAS  PubMed  Google Scholar 

  25. Farshad M, Gerber C (2010) Reverse total shoulder arthroplasty-from the most to the least common complication. Int Orthop 34:1075–1082. doi:10.1007/s00264-010-1125-2

    Article  PubMed  PubMed Central  Google Scholar 

  26. Castagna A, Delcogliano M, de Caro F, Ziveri G, Borroni M, Gumina S, Postacchini F, De Biase CF (2013) Conversion of shoulder arthroplasty to reverse implants: clinical and radiological results using a modular system. Int Orthop 37:1297–1305. doi:10.1007/s00264-013-1907-4

    Article  PubMed  PubMed Central  Google Scholar 

  27. Werner BS, Boehm D, Gohlke F (2013) Revision to reverse shoulder arthroplasty with retention of the humeral component. Acta Orthop 84:473–478. doi:10.3109/17453674.2013.842433

    Article  PubMed  PubMed Central  Google Scholar 

  28. Weber-Spickschen TS, Alfke D, Agneskirchner JD (2015) The use of a modular system to convert an anatomical total shoulder arthroplasty to a reverse shoulder arthroplasty: Clinical and radiological results. Bone Joint J 97-B:1662–1667. doi:10.1302/0301-620X.97B12.35176

    Article  CAS  PubMed  Google Scholar 

  29. Trappey GJ, O’Connor DP, Edwards TB (2011) What are the instability and infection rates after reverse shoulder arthroplasty? Clin Orthop Relat Res 469:2505–2511. doi:10.1007/s11999-010-1686-9

    Article  PubMed  Google Scholar 

  30. Mahmood A, Malal JJ, Waseem M (2013) Reverse shoulder arthroplasty—a literature review. Open Orthop J 7:366–372. doi:10.2174/1874325001307010366

    Article  PubMed  PubMed Central  Google Scholar 

  31. Flury MP, Frey P, Goldhahn J, Schwyzer HK, Simmen BR (2011) Reverse shoulder arthroplasty as a salvage procedure for failed conventional shoulder replacement due to cuff failure—midterm results. Int Orthop 35:53–60. doi:10.1007/s00264-010-0990-z

    Article  PubMed  Google Scholar 

  32. Nicholson GP, Strauss EJ, Sherman SL (2011) Scapular notching: recognition and strategies to minimize clinical impact. Clin Orthop Relat Res 469:2521–2530. doi:10.1007/s11999-010-1720-y

    Article  PubMed  Google Scholar 

  33. Gutierrez S, Keller TS, Levy JC, Lee WE 3rd, Luo ZP (2008) Hierarchy of stability factors in reverse shoulder arthroplasty. Clin Orthop Relat Res 466:670–676. doi:10.1007/s11999-007-0096-0

    Article  PubMed  PubMed Central  Google Scholar 

  34. Nyffeler RW, Werner CM, Gerber C (2005) Biomechanical relevance of glenoid component positioning in the reverse Delta III total shoulder prosthesis. J Shoulder Elbow Surg 14:524–528. doi:10.1016/j.jse.2004.09.010

    Article  PubMed  Google Scholar 

  35. Simovitch RW, Zumstein MA, Lohri E, Helmy N, Gerber C (2007) Predictors of scapular notching in patients managed with the Delta III reverse total shoulder replacement. J Bone Joint Surg Am 89:588–600. doi:10.2106/JBJS.F.00226

    PubMed  Google Scholar 

  36. Levigne C, Boileau P, Favard L, Garaud P, Mole D, Sirveaux F, Walch G (2008) Scapular notching in reverse shoulder arthroplasty. J Shoulder Elbow Surg 17:925–935. doi:10.1016/j.jse.2008.02.010

    Article  PubMed  Google Scholar 

  37. Loew M (2013) Short stem shoulder prosthesis: concept and first results. Orthopade 42:501–506. doi:10.1007/s00132-012-2021-9

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. Holschen.

Ethics declarations

Conflict of interest

All authors of this study do not have any conflicts of interest related to the subject of this work.

Ethical approval

Ethical approval was given from the ethical committee of the medical faculty of the University of Münster, Münster, Germany on September 6th 2013 (Study Number: 2013-229-f-S).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Holschen, M., Franetzki, B., Witt, KA. et al. Is reverse total shoulder arthroplasty a feasible treatment option for failed shoulder arthroplasty? A retrospective study of 44 cases with special regards to stemless and stemmed primary implants. Musculoskelet Surg 101, 173–180 (2017). https://doi.org/10.1007/s12306-017-0467-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12306-017-0467-y

Keywords

Navigation