title: Reverse total shoulder arthroplasty for failed shoulder arthroplasty.
abstract: BACKGROUND
  Shoulder arthroplasty provides excellent outcomes for most patients; however, a subset of these patients with a failed arthroplasty will require revision. Recently, the reverse total shoulder arthroplasty (rTSA) has been used in these difficult clinical situations. Therefore, we sought to examine our initial experience using rTSA as a treatment for failed shoulder arthroplasty.
  
  
  METHODS
  During a 5-year period, 31 patients (mean age, 68.7 years) underwent rTSA for treatment of a failed shoulder arthroplasty and their presurgical and operative data were analyzed. Of the 31 patients, 28 were available for an average follow-up of 40.7 months. Their outcomes were assessed with American Shoulder and Elbow Surgeons (ASES), University of California-Los Angeles (UCLA), and Simple Shoulder Test (SST) scores, and the visual analog scale (VAS) for pain.
  
  
  RESULTS
  Compared with preoperative status, there were statistically significant improvements in all outcome measurements, including the ASES (24.0 to 66.2), UCLA (7.4 to 23.5), SST (1.5 to 7.6), and VAS (7.0 to 2.6). Active forward elevation improved from 44° preoperatively to 108° postoperatively (P < .001). Results were rated as good or excellent by 19 patients (67.9%), satisfactory by 4 (14.3%), and unsatisfactory by 5 (17.8%). Among the types of failed arthroplasty, patients with failed TSA noted the greatest improvement in their outcome, but this improvement was not statistically significant.
  
  
  CONCLUSIONS
  The data suggest that patients can expect improved functional outcome and decreased pain after revision of previous arthroplasty to rTSA and that this procedure can provide a reliable salvage option for a challenging clinical problem.
authors.affiliation: Department of Orthopaedic Surgery, New York University Hospital of Joint Diseases, New York, NY 10003, USA. deepan.patel@nyumc.org
authors.forename: Deepan N
authors.initials: DN
authors.lastname: Patel
authors.forename: Brett
authors.initials: B
authors.lastname: Young
authors.forename: Ikemefuna
authors.initials: I
authors.lastname: Onyekwelu
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Zuckerman
authors.forename: Young W
authors.initials: YW
authors.lastname: Kwon
mesh_terms: D000368:Aged; D019643:Arthroplasty, Replacement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D010003:Osteoarthritis / Q000503:physiopathology / Q000601:surgery*; D010147:Pain Measurement; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome