title: Revision to reverse shoulder arthroplasty with retention of the humeral component.
abstract: BACKGROUND
  Revision in failed shoulder arthroplasty often requires removal of the humeral component with a significant risk of fracture and bone loss. Newer modular systems allow conversion from anatomic to reverse shoulder arthroplasty with retention of a well-fixed humeral stem. We report on a prospectively evaluated series of conversions from hemiarthroplasty to reverse shoulder arthroplasty.
  
  
  METHODS
  In 14 cases of failed hemiarthroplasty due to rotator cuff deficiency and painful pseudoparalysis (in 13 women), revision to reverse shoulder arthroplasty was performed between October 2006 and 2010, with retention of the humeral component using modular systems. Mean age at the time of operation was 70 (56-80) years. Pre- and postoperative evaluation followed a standardized protocol including Constant score, range of motion, and radiographic analysis. Mean follow-up time was 2.5 (2-5.5) years.
  
  
  RESULTS
  Mean Constant score improved from 9 (2-16) to 41 (17-74) points. Mean lengthening of the arm was 2.6 (0.9-4.7) cm without any neurological complications. One patient required revision due to infection.
  
  
  CONCLUSIONS
  Modular systems allow retainment of a well-fixed humeral stem with good outcome. There is a risk of excessive humeral lengthening.
authors.affiliation: Department of Orthopaedics and Trauma Surgery , Franziskus-Hospital Harderberg , Georgsmarienhütte.
authors.forename: Birgit S
authors.initials: BS
authors.lastname: Werner
authors.forename: Dorota
authors.initials: D
authors.lastname: Boehm
authors.forename: Frank
authors.initials: F
authors.lastname: Gohlke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020878:Device Removal / Q000379:methods; D005260:Female; D062785:Hemiarthroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery; D006811:Humerus / Q000601:surgery*; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology / Q000601:surgery; D010243:Paralysis / Q000209:etiology / Q000601:surgery; D017060:Patient Satisfaction; D011446:Prospective Studies; D011475:Prosthesis Failure / Q000209:etiology; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation / Q000706:statistics & numerical data; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D013530:Surgical Wound Infection / Q000209:etiology
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