Revision of an unstable hemiarthroplasty or anatomical total shoulder replacement using a reverse design prosthesis

Matthew Abdel, S. J. Hattrup, J. W. Sperling, R. H. Cofield, C. R. Kreofsky, J. Sanchez-Sotelo

Research output: Contribution to journalReview article

28 Citations (Scopus)

Abstract

Instability after arthroplasty of the shoulder is difficult to correct surgically. Soft-tissue procedures and revision surgery using unconstrained anatomical components are associated with a high rate of failure. The purpose of this study was to determine the results of revision of an unstable anatomical shoulder arthroplasty to a reverse design prosthesis. Between 2004 and 2007, 33 unstable anatomical shoulder arthroplasties were revised to a reverse design. The mean age of the patients was 71 years (53 to 86) and their mean followup was 42 months (25 to 71). The mean time to revision was 26 months (4 to 164). Pain scores improved significantly (pre-operative visual analogue scale (VAS) of 7.2 (SD 1.6); most recent VAS 2.2 (SD 1.9); p = 0.001). There was a statistically significant increase in mean active forward elevation from 40.2° (SD 27.3) to 97.0° (SD 36.2) (p = 0.001). There was no significant difference in internal (p = 0.93) or external rotation (p = 0.40). Radiological findings included notching in five shoulders (15%) and heterotopic ossification of the inferior capsular region in three (9%). At the last follow-up 31 shoulders (94%) were stable. The remaining two shoulders dislocated at 2.5 weeks and three months post-operatively, respectively. According to the Neer rating system, there were 13 excellent (40%), ten satisfactory (30%) and ten unsatisfactory results (30%). Revision of hemiarthroplasty or anatomical total shoulder replacement for instability using a reverse design prosthesis gives good short-term results.

Original languageEnglish (US)
Pages (from-to)668-672
Number of pages5
JournalBone and Joint Journal
Volume95 B
Issue number5
DOIs
StatePublished - Jan 1 2013

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Prosthesis Design
Hemiarthroplasty
Arthroplasty
Visual Analog Scale
Heterotopic Ossification
Reoperation
Shoulder Replacement Arthroplasty
Pain

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Revision of an unstable hemiarthroplasty or anatomical total shoulder replacement using a reverse design prosthesis. / Abdel, Matthew; Hattrup, S. J.; Sperling, J. W.; Cofield, R. H.; Kreofsky, C. R.; Sanchez-Sotelo, J.

In: Bone and Joint Journal, Vol. 95 B, No. 5, 01.01.2013, p. 668-672.

Research output: Contribution to journalReview article

Abdel, Matthew ; Hattrup, S. J. ; Sperling, J. W. ; Cofield, R. H. ; Kreofsky, C. R. ; Sanchez-Sotelo, J. / Revision of an unstable hemiarthroplasty or anatomical total shoulder replacement using a reverse design prosthesis. In: Bone and Joint Journal. 2013 ; Vol. 95 B, No. 5. pp. 668-672.
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abstract = "Instability after arthroplasty of the shoulder is difficult to correct surgically. Soft-tissue procedures and revision surgery using unconstrained anatomical components are associated with a high rate of failure. The purpose of this study was to determine the results of revision of an unstable anatomical shoulder arthroplasty to a reverse design prosthesis. Between 2004 and 2007, 33 unstable anatomical shoulder arthroplasties were revised to a reverse design. The mean age of the patients was 71 years (53 to 86) and their mean followup was 42 months (25 to 71). The mean time to revision was 26 months (4 to 164). Pain scores improved significantly (pre-operative visual analogue scale (VAS) of 7.2 (SD 1.6); most recent VAS 2.2 (SD 1.9); p = 0.001). There was a statistically significant increase in mean active forward elevation from 40.2° (SD 27.3) to 97.0° (SD 36.2) (p = 0.001). There was no significant difference in internal (p = 0.93) or external rotation (p = 0.40). Radiological findings included notching in five shoulders (15{\%}) and heterotopic ossification of the inferior capsular region in three (9{\%}). At the last follow-up 31 shoulders (94{\%}) were stable. The remaining two shoulders dislocated at 2.5 weeks and three months post-operatively, respectively. According to the Neer rating system, there were 13 excellent (40{\%}), ten satisfactory (30{\%}) and ten unsatisfactory results (30{\%}). Revision of hemiarthroplasty or anatomical total shoulder replacement for instability using a reverse design prosthesis gives good short-term results.",
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