title: Revision reverse shoulder arthroplasty in failed shoulder arthroplasties for rotator cuff deficiency.
abstract: OBJECTIVE
  the aim of this systematic literature review is to report clinical outcomes of reverse shoulder arthroplasty (RSA) used as a revision surgery following failure of the primary implant due to rotator cuff insufficiency.
  
  
  METHODS
  a systematic review was performed using the following key words: revision, shoulder, rotator cuff deficiency, outcome assessment, treatment outcome, complications. Studies eligible for inclusion in the review were clinical trials investigating patients in whom a primary shoulder arthroplasty implant with an incompetent rotator cuff was replaced with a reverse shoulder prosthesis.
  
  
  RESULTS
  nine articles were identified and further reviewed. The results refer to a total of 226 shoulders that were treated with RSA as revision surgery. The patients in the studies had a mean age ranging from 64 to 72 years and the longest follow-up was 3.8 years. Improvements in function and reduction of pain were shown by many studies, but the mean Constant score ranged from 44.2 to 56. High complication rates (of up to 62%) were recorded, and a mean reoperation rate of 27.5%.
  
  
  CONCLUSIONS
  RSA as revision surgery for patients with rotator cuff deficiency is a valid option, and often the only solution available, but it should be limited to elderly patients with poor function and severe pain.
  
  
  METHODS
  level IV, systematic review of level I-IV studies.
authors.affiliation: IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Randelli
authors.affiliation: IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Randelli
authors.affiliation: Department of Orthopedics and Traumatology, "Bolognini" Hospital, Seriate, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Compagnoni
authors.affiliation: IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Cabitza
authors.affiliation: IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Vincenza
authors.initials: V
authors.lastname: Ragone
authors.affiliation: IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Pulici
authors.affiliation: IRCCS Istituto Ortopedico "Galeazzi", Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Banfi
keywords: failure; reverse; revision; rotator cuff tear; shoulder arthroplasty