DOS Kongressen 2014 ·
105
Complications and revision surgery of the reverse
shoulder arthroplasty
Janne Ovesen, Thomas Falstie Jensen, Hans Viggo Skjeldborg Johannsen
Shoulder and Elbow Clinic. Department of Orthopaedic Surgery., Aarhus
Universityhospital
Background:
The indications for reverse total shoulder arthroplasty (RTSA)
have expanded, but there is relatively limited knowledge regarding longterm re-
sults after revisions of the RTSA.
Purpose / Aim of Study:
To identify and understand the most common com-
plications and reasons for failure in RTSA.
Materials and Methods:
Between 2003 and 2014, 37 patients with RTSA had
revision surgery. Clinical and radiographic examinations were performed preop-
eratively, postoperatively and analyzed retrospectively. Revision was defined as
a surgical intervention with exchange or removal of one or more components.
Causes for revision were identified and the patients were reviewed with a mean
of 56 months follow-up after the first intervention.
Findings / Results:
37 patients with a mean age of 70.1 years (51 to 83),
needed at least one additional intervention to treat a complication of RTSA.
Additional interventions after RTSA were needed between the second day of
the RTSA and 11 years thereafter, with mean of 21.4 months postoperatively.
The most common causes for revision were infection (62.2%), prosthetic in-
stability (24.3%), humeral loosening, fracture (5.4%), glenoid loosening (5.4%)
and other reasons (2.7%). At follow-up 17 patients had retained a RTSA, 17 pa-
tients had undergone conversion to hemiartroplasty and 3 patients had chosen
to keep the cementspacer. Previous surgery was found to be a potential cause
of low-grade infection.
Conclusions:
The most frequent causes for revision of a failed RTSA were in-
fection and instability. Previous failed surgery was a risk factor for revision RTSA,
in particular failed treatment for fracture (hemiarthroplasty or osteosynthesis)
and failed cuffrepair. Revision of RTSA may lead to several surgical procedures
in the same patient. Preservation or replacement of the RTSA, allowing a func-
tional shoulder, was in most cases possible.
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