title: Results of 30 reverse shoulder prostheses for revision of failed hemi- or total shoulder arthroplasty.
abstract: OBJECTIVE
  Revision surgery for shoulder prosthesis remains a difficult task in shoulder surgery. The purpose of this retrospective study was to evaluate the clinical and radiological outcomes of a series of 30 reverse shoulder prostheses performed as revision of failed hemi- or total shoulder arthroplasty. The most relevant technical points in surgery are described, as are other surgical options; a rational strategy for the treatment of these patients is proposed.
  
  
  METHODS
  Thirty patients (average age 69.5) were included. Mean follow-up was 36.4 months (range 24-100 months). There were 14 patients in group 1 (Delta III) and 16 in group 2 (Reverse Arrow).
  
  
  RESULTS
  A total of 83% were satisfied (16 cases) or very satisfied (9 cases), and 17% were disappointed (5 patients). The mean Constant score increased from a mean of 25-52. The mean score for pain improved from 5 (range 0-15) to 13 (range 5-15) (p < 0.001). The mean score of strength improved from 1 (range 0-6) to 5 (range 0-10) (p < 0.001). The forward elevation changed from a mean of 55° (range 0-120) to 108° (range 40-160) (p < 0.001). There was no significant improvement of external rotation at 0° abduction (range 14°-18°) or internal rotation (range 5-4.63). There were 4 scapular notching. We could not find the influence of scapular notching on Constant Score. Complication rate was 26.6%.
  
  
  CONCLUSIONS
  Reverse total shoulder arthroplasty prosthesis represents an available option in difficult cases of failed hemiarthroplasty or total shoulder arthroplasty when the rotator cuff is irreparable and the glenoid bone stock is sufficient.
  
  
  METHODS
  Level 4.
authors.affiliation: Institut de la Main, Clinique Jouvenet, 6 Square Jouvenet, 75016, Paris, France, philippe.valenti@wanadoo.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Valenti
authors.forename: Alexandre Sahin
authors.initials: AS
authors.lastname: Kilinc
authors.forename: Philippe
authors.initials: P
authors.lastname: Sauzières
authors.forename: Denis
authors.initials: D
authors.lastname: Katz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000009:adverse effects / Q000379:methods*; D005260:Female; D062785:Hemiarthroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011475:Prosthesis Failure / Q000009:adverse effects; D012086:Reoperation; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000601:surgery*; D020069:Shoulder Pain / Q000209:etiology