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Revision Total Shoulder Arthroplasty: Complications and Results

  • Alfonso Vaquero-Picado
  • Samuel Antuña
  • Raul Barco
Chapter

Abstract

Shoulder arthroplasty implantation has become a more and more common procedure in the last decades to address multiple shoulder pathologies. Increased implantation has led to increased rate of complications and revision surgery. In the last two decades, reverse shoulder arthroplasty (RSA) has become the standard for revision surgery. It is a more stable implant and allows addressing severe anatomy distortions, bone loss and insufficient function of the rotator cuff. Instability was the most common complication with the Grammont-style designs, but its incidence has decreased with new designs. Infection is a catastrophic and challenging complication. Diagnosis is difficult and diverse protocols combining surgery and prolonged antibiotherapy have been used. Bone loss, either in the proximal humerus or on the glenoid side, is also frequent. Its management includes structural or morcellized bone supplementation, allograft prosthetic composite or megaprosthesis. In case of severe instability or glenoid deficiency, hemiarthroplasty can be used as a salvage procedure. Functional results after revision are consistently worse than results after primary procedures.

Keywords

Shoulder prosthesis complications Revision shoulder prosthesis 

References

  1. 1.
    Kim SH, Wise BL, Zhang Y, Szabo RM. Increasing incidence of shoulder arthroplasty in the United States. J Bone Joint Surg Am. 2011;93:2249–54.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Dillon MT, Chan PH, Inacio MCS, Singh A, Yian EH, Navarro RA. Yearly trends in elective shoulder arthroplasty, 2005-2013. Arthritis Care Res. 2017;69:1574–81.CrossRefGoogle Scholar
  3. 3.
    Harjula JNE, Paloneva J, Haapakoski J, Kukkonen J, Äärimaa V, Finnish Shoulder Arthroplasty Registry Group. Increasing incidence of primary shoulder arthroplasty in Finland—a nationwide registry study. BMC Musculoskelet Disord. 2018;19:245.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Wagner ER, Chang MJ, Welp KM, Solberg MJ, Hunt TJ, Woodmass JM, et al. The impact of the reverse prosthesis on revision shoulder arthroplasty: analysis of a high-volume shoulder practice. J Shoulder Elb Surg. 2019;28:e49–56.CrossRefGoogle Scholar
  5. 5.
    Zumstein MA, Pinedo M, Old J, Boileau P. Problems, complications, reoperations, and revisions in reverse total shoulder arthroplasty: a systematic review. J Shoulder Elb Surg. 2011;20:146–57.CrossRefGoogle Scholar
  6. 6.
    Barco R, Savvidou OD, Sperling JW, Sanchez-Sotelo J, Cofield RH. Complications in reverse shoulder arthroplasty. EFORT Open Rev. 2016;1:72–80.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Boileau P, Melis B, Duperron D, Moineau G, Rumian AP, Han Y. Revision surgery of reverse shoulder arthroplasty. J Shoulder Elb Surg. 2013;22:1359–70.CrossRefGoogle Scholar
  8. 8.
    Boileau P. Complications and revision of reverse total shoulder arthroplasty. Orthop Traumatol Surg Res OTSR. 2016;102:S33–43.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Neer CS. Articular replacement for the humeral head. J Bone Joint Surg Am. 1955;37-A:215–28.CrossRefGoogle Scholar
  10. 10.
    Neer CS, Watson KC, Stanton FJ. Recent experience in total shoulder replacement. J Bone Joint Surg Am. 1982;64:319–37.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Grammont P, Trouillloud P, Laffay J, Deries X. Étude et realisation d’une nouvelle prothèse d’épaule. Rhumatologie. 1987;39:409–18.Google Scholar
  12. 12.
    Sheth MM, Sholder D, Getz CL, Williams GR, Namdari S. Revision of failed hemiarthroplasty and anatomic total shoulder arthroplasty to reverse total shoulder arthroplasty. J Shoulder Elb Surg. 2019;28:1074–81.CrossRefGoogle Scholar
  13. 13.
    Wagner ER, Hevesi M, Houdek MT, Cofield RH, Sperling JW, Sanchez-Sotelo J. Can a reverse shoulder arthroplasty be used to revise a failed primary reverse shoulder arthroplasty?: revision reverse shoulder arthroplasty for failed reverse prosthesis. Bone Joint J. 2018;100-B:1493–8.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Shields E, Wiater JM. Patient outcomes after revision of anatomic total shoulder arthroplasty to reverse shoulder arthroplasty for rotator cuff failure or component loosening: a matched cohort study. J Am Acad Orthop Surg. 2019;27:e193–8.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Petkovic D, Kovacevic D, Levine WN, Jobin CM. Management of the failed arthroplasty for proximal humerus fracture. J Am Acad Orthop Surg. 2019;27:39–49.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Stephens BC, Simon P, Clark RE, Christmas KN, Stone GP, Lorenzetti AJ, et al. Revision for a failed reverse: a 12-year review of a lateralized implant. J Shoulder Elb Surg. 2016;25:e115–24.CrossRefGoogle Scholar
  17. 17.
    Lehtimäki K, Rasmussen JV, Mokka J, Salomonsson B, Hole R, Jensen SL, et al. Risk and risk factors for revision after primary reverse shoulder arthroplasty for cuff tear arthropathy and osteoarthritis: a Nordic Arthroplasty Register Association study. J Shoulder Elb Surg. 2018;27:1596–601.CrossRefGoogle Scholar
  18. 18.
    Boddapati V, Fu MC, Schairer WW, Gulotta LV, Dines DM, Dines JS. Revision total shoulder arthroplasty is associated with increased thirty-day postoperative complications and wound infections relative to primary total shoulder arthroplasty. HSS J. 2018;14:23–8.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Ingoe HM, Holland P, Cowling P, Kottam L, Baker PN, Rangan A. Intraoperative complications during revision shoulder arthroplasty: a study using the National Joint Registry dataset. Shoulder Elb. 2017;9:92–9.CrossRefGoogle Scholar
  20. 20.
    Teusink MJ, Pappou IP, Schwartz DG, Cottrell BJ, Frankle MA. Results of closed management of acute dislocation after reverse shoulder arthroplasty. J Shoulder Elb Surg. 2015;24:621–7.CrossRefGoogle Scholar
  21. 21.
    Kang JR, Dubiel MJ, Cofield RH, Steinmann SP, Elhassan BT, Morrey ME, et al. Primary reverse shoulder arthroplasty using contemporary implants is associated with very low reoperation rates. J Shoulder Elb Surg. 2019;28(6S):S175–80.  https://doi.org/10.1016/j.jse.2019.01.026. pii: S1058-2746(19)30077-1CrossRefGoogle Scholar
  22. 22.
    Werner BC, Burrus MT, Begho I, Gwathmey FW, Brockmeier SF. Early revision within 1 year after shoulder arthroplasty: patient factors and etiology. J Shoulder Elb Surg. 2015;24:e323–30.CrossRefGoogle Scholar
  23. 23.
    Alentorn-Geli E, Clark NJ, Assenmacher AT, Samuelsen BT, Sánchez-Sotelo J, Cofield RH, et al. What are the complications, survival, and outcomes after revision to reverse shoulder arthroplasty in patients older than 80 years? Clin Orthop Relat Res. 2017;475:2744–51.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Randelli P, Randelli F, Compagnoni R, Cabitza P, Ragone V, Pulici L, et al. Revision reverse shoulder arthroplasty in failed shoulder arthroplasties for rotator cuff deficiency. Joints. 2015;3:31–7.PubMedPubMedCentralGoogle Scholar
  25. 25.
    Hernandez NM, Chalmers BP, Wagner ER, Sperling JW, Cofield RH, Sanchez-Sotelo J. Revision to reverse total shoulder arthroplasty restores stability for patients with unstable shoulder prostheses. Clin Orthop Relat Res. 2017;475:2716–22.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Abdelfattah A, Otto RJ, Simon P, Christmas KN, Tanner G, LaMartina J, et al. Classification of instability after reverse shoulder arthroplasty guides surgical management and outcomes. J Shoulder Elb Surg. 2018;27:e107–18.CrossRefGoogle Scholar
  27. 27.
    Chalmers PN, Rahman Z, Romeo AA, Nicholson GP. Early dislocation after reverse total shoulder arthroplasty. J Shoulder Elb Surg. 2014;23:737–44.CrossRefGoogle Scholar
  28. 28.
    Pottinger P, Butler-Wu S, Neradilek MB, Merritt A, Bertelsen A, Jette JL, et al. Prognostic factors for bacterial cultures positive for Propionibacterium acnes and other organisms in a large series of revision shoulder arthroplasties performed for stiffness, pain, or loosening. J Bone Joint Surg Am. 2012;94:2075–83.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Favard L. Revision of total shoulder arthroplasty. Orthop Traumatol Surg Res. 2013;99:S12–21.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Dennison T, Alentorn-Geli E, Assenmacher AT, Sperling JW, Sánchez-Sotelo J, Cofield RH. Management of acute or late hematogenous infection after shoulder arthroplasty with irrigation, débridement, and component retention. J Shoulder Elb Surg. 2017;26:73–8.CrossRefGoogle Scholar
  31. 31.
    Marcheggiani Muccioli GM, Guerra E, Roberti di Sarsina T, Alesi D, Fratini S, Cammisa E, et al. Diagnosis and treatment of infected shoulder arthroplasty: current concepts review. Joints. 2018;6:173–6.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Lutz M-F, Berthelot P, Fresard A, Cazorla C, Carricajo A, Vautrin A-C, et al. Arthroplastic and osteosynthetic infections due to Propionibacterium acnes: a retrospective study of 52 cases, 1995-2002. Eur J Clin Microbiol Infect Dis. 2005;24:739–44.CrossRefGoogle Scholar
  33. 33.
    Asseray N, Papin C, Touchais S, Bemer P, Lambert C, Boutoille D, et al. Improving diagnostic criteria for Propionibacterium acnes osteomyelitis: a retrospective analysis. Scand J Infect Dis. 2010;42:421–5.CrossRefGoogle Scholar
  34. 34.
    Tseng W-J, Lansdown DA, Grace T, Zhang AL, Feeley BT, Hung L-W, et al. Outcomes of revision arthroplasty for shoulder periprosthetic joint infection: a three-stage revision protocol. J Shoulder Elb Surg. 2019;28:268–75.CrossRefGoogle Scholar
  35. 35.
    Sevelda F, Fink B. One-stage exchange of septic shoulder arthroplasty following a standardized treatment algorithm. J Shoulder Elb Surg. 2018;27:2175–82.CrossRefGoogle Scholar
  36. 36.
    Mercurio M, Castioni D, Iannò B, Gasparini G, Galasso O. Outcomes of revision surgery after periprosthetic shoulder infection: a systematic review. J Shoulder Elb Surg. 2019;28:1193–203.CrossRefGoogle Scholar
  37. 37.
    Kunutsor SK, Wylde V, Beswick AD, Whitehouse MR, Blom AW. One- and two-stage surgical revision of infected shoulder prostheses following arthroplasty surgery: a systematic review and meta-analysis. Sci Rep. 2019;9:232.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Assenmacher AT, Alentorn-Geli E, Dennison T, Baghdadi YMK, Cofield RH, Sánchez-Sotelo J, et al. Two-stage reimplantation for the treatment of deep infection after shoulder arthroplasty. J Shoulder Elb Surg. 2017;26:1978–83.CrossRefGoogle Scholar
  39. 39.
    Buchalter DB, Mahure SA, Mollon B, Yu S, Kwon YW, Zuckerman JD. Two-stage revision for infected shoulder arthroplasty. J Shoulder Elb Surg. 2017;26:939–47.CrossRefGoogle Scholar
  40. 40.
    Stone GP, Clark RE, O’Brien KC, Vaccaro L, Simon P, Lorenzetti AJ, et al. Surgical management of periprosthetic shoulder infections. J Shoulder Elb Surg. 2017;26:1222–9.CrossRefGoogle Scholar
  41. 41.
    Stephens SP, Paisley KC, Giveans MR, Wirth MA. The effect of proximal humeral bone loss on revision reverse total shoulder arthroplasty. J Shoulder Elb Surg. 2015;24:1519–26.CrossRefGoogle Scholar
  42. 42.
    Cox JL, McLendon PB, Christmas KN, Simon P, Mighell MA, Frankle MA. Clinical outcomes following reverse shoulder arthroplasty-allograft composite for revision of failed arthroplasty associated with proximal humeral bone deficiency: 2- to 15-year follow-up. J Shoulder Elb Surg. 2019;28:900–7.CrossRefGoogle Scholar
  43. 43.
    Sanchez-Sotelo J, Wagner ER, Sim FH, Houdek MT. Allograft-prosthetic composite reconstruction for massive proximal humeral bone loss in reverse shoulder arthroplasty. J Bone Joint Surg Am. 2017;99:2069–76.CrossRefGoogle Scholar
  44. 44.
    Lucas RM, Hsu JE, Whitney IJ, Wasserburger J, Matsen FA. Loose glenoid components in revision shoulder arthroplasty: is there an association with positive cultures? J Shoulder Elb Surg. 2016;25:1371–5.CrossRefGoogle Scholar
  45. 45.
    Ozgur SE, Sadeghpour R, Norris TR. Revision shoulder arthroplasty with a reverse shoulder prosthesis: use of structural allograft for glenoid bone loss. Orthopade. 2017;46:1055–62.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Wagner E, Houdek MT, Griffith T, Elhassan BT, Sanchez-Sotelo J, Sperling JW, et al. Glenoid bone-grafting in revision to a reverse total shoulder arthroplasty. J Bone Joint Surg Am. 2015;97:1653–60.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Mahylis JM, Puzzitiello RN, Ho JC, Amini MH, Iannotti JP, Ricchetti ET. Comparison of radiographic and clinical outcomes of revision reverse total shoulder arthroplasty with structural versus nonstructural bone graft. J Shoulder Elb Surg. 2019;28:e1–9.CrossRefGoogle Scholar
  48. 48.
    Phipatanakul WP, Norris TR. Treatment of glenoid loosening and bone loss due to osteolysis with glenoid bone grafting. J Shoulder Elb Surg. 2006;15:84–7.CrossRefGoogle Scholar
  49. 49.
    Norris TR. Glenoid bone loss in reverse shoulder arthroplasty treated with bone graft techniques. Am J Orthop (Belle Mead NJ). 2018;47(3)  https://doi.org/10.12788/ajo.2018.0016.
  50. 50.
    Glanzmann MC, Kolling C, Schwyzer H-K, Audigé L. Conversion to hemiarthroplasty as a salvage procedure for failed reverse shoulder arthroplasty. J Shoulder Elb Surg. 2016;25:1795–802.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Alfonso Vaquero-Picado
    • 1
  • Samuel Antuña
    • 1
  • Raul Barco
    • 1
  1. 1.Upper Limb Unit, Department of OrthopedicsHospital Universitario La PazMadridSpain

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