title: Clinical results of revision shoulder arthroplasty for glenoid component loosening.
abstract: We retrospectively reviewed 32 patients who underwent glenoid revision surgery after total shoulder arthroplasty to compare the results of revision total shoulder arthroplasty with those of revision hemiarthroplasty and to identify factors associated with poor results after revision shoulder arthroplasty for glenoid component loosening. Results were reviewed at a mean follow-up of 4 years (range, 2-8 years). Glenoid reimplantation resulted in significant pain relief (P < .0001), improvement in American Shoulder and Elbow Surgeons (ASES) score (P < .02), and external rotation (24 degrees to 44 degrees , P < .004). Revision to a hemiarthroplasty also resulted in significant pain relief (P < .01) and improvement in ASES score (P < .05). For the treatment of glenoid loosening without glenohumeral instability, both reimplantation of a glenoid component and revision to a hemiarthroplasty improved function, satisfaction, and level of pain. Reimplantation of a new glenoid component offered greater improvements in pain (P < .008) and external rotation (increase of 20 degrees versus 3 degrees , P < .03) compared with hemiarthroplasty. For patients with preoperative glenohumeral instability, revision surgery did not improve motion, function, or pain significantly. Risk factors associated with a poor outcome after revision arthroplasty included persistent glenohumeral instability, rotator cuff tears, and malunion of the greater tuberosity.
authors.affiliation: Department of Orthopaedics, Kelsey Seybold Clinic, Houston, TX, USA.
authors.forename: Allen
authors.initials: A
authors.lastname: Deutsch
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Abboud
authors.forename: James
authors.initials: J
authors.lastname: Kelly
authors.forename: Milan
authors.initials: M
authors.lastname: Mody
authors.forename: Tom
authors.initials: T
authors.lastname: Norris
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Ramsey
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Iannotti
authors.forename: Gerald R
authors.initials: GR
authors.lastname: Williams
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001178:Arthroplasty / Q000379:methods*; D005260:Female; D006801:Humans; D007593:Joint Instability; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000601:surgery; D010147:Pain Measurement; D011475:Prosthesis Failure; D016059:Range of Motion, Articular; D012086:Reoperation; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome