title: Revision Total Shoulder Arthroplasty without Humeral Component Removal. A Preliminary Report on the Role of a Platform Humeral Component.
abstract: BACKGROUND
  Revision total shoulder arthroplasty to a reverse system without removing the humeral component-- i.e., a platform system--has been in use since 2006. This preliminary report compares the outcomes of revision total shoulder replacement in patients who underwent revision utilizing a platform system as compared to those patients requiring stem removal.
  
  
  METHODS
  The data banks from two academic centers were utilized to review patients who underwent revision total shoulder surgery requiring removal of a well fixed humeral stem and those revised with a well fixed platform humeral stem. All patients underwent revision to reverse total shoulder arthroplasty. Measured variables were pre and postoperative Constant scores, blood loss, operating room time, complications, and cost.
  
  
  RESULTS
  The use of a platform system resulted in fewer complications, less operating room time, and a decrease in blood loss (p < 0.05). The Constant scores were not significantly different between the two groups. The cost of implants and operating room time was also less in the platform system group.
  
  
  CONCLUSIONS
  Revision total shoulder arthroplasty utilizing a platform system that does not require humeral component removal resulted in a significant decrease in complications, blood loss, and operating room time compared with revisions that did not utilize a platform system. The Constant score was similar between the two groups. The overall cost of the procedure was less when the platform system was used.
authors.forename: Lynn A
authors.initials: LA
authors.lastname: Crosby
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Wright
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Zuckerman
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation* / Q000379:methods; D001696:Biomechanical Phenomena; D016063:Blood Loss, Surgical; D016208:Databases, Factual; D020878:Device Removal; D005260:Female; D005431:Florida; D005845:Georgia; D017721:Hospital Costs; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D011474:Prosthesis Design; D011859:Radiography; D012086:Reoperation; D012307:Risk Factors; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome