title: Functional results of bilateral reverse total shoulder arthroplasty.
abstract: BACKGROUND
  The purpose of this study was to analyze a population of patients with bilateral reverse total shoulder arthroplasty (RTSA) to evaluate their ability to perform activities of daily living and personal hygiene tasks.
  
  
  METHODS
  At a minimum 2-year follow-up, we retrospectively reviewed 50 patients (100 shoulders) with a mean age of 72 years who underwent staged bilateral RTSA. The average follow-up period was 61 months (range, 24-121 months), with a minimum 2-year follow-up after the second surgical procedure. Functional outcomes were assessed with American Shoulder and Elbow Surgeons, Simple Shoulder Test, and Short Form 12 (SF-12) scores. In addition, a unique questionnaire regarding personal hygiene habits and activities of daily living reliant on shoulder rotation was administered to all patients.
  
  
  RESULTS
  Patients showed significant improvements in pain (mean improvement in visual analog scale score from 5.7 to 1.0, P < .001) and forward elevation (mean improvement from 71° to 136°, P < .001). Clinical outcome scores showed significant improvements: The mean American Shoulder and Elbow Surgeons score improved from 35.8 to 76.5 (P < .001), Simple Shoulder Test score improved from 2.4 to 8.0 (P < .001), SF-12 mental component subscore improved from 51.9 to 54.1 (P < .001), and SF-12 physical component subscore improved from 30.5 to 39.7 (P < .001). Internal and external rotation showed significant improvements (from 33° to 53° [P < .005] and from 27° to 44° [P < .001], respectively). All patients retained independence with personal hygiene and activities of daily living. Complications included prosthetic instability (3%), acromial fracture (5%), and periprosthetic joint infection (1%). The overall reoperation rate was 5%.
  
  
  CONCLUSIONS
  Bilateral RTSA provides predictable pain relief and improved function. Hygiene practices are unaltered for most patients, and the other patients rapidly develop simple compensatory strategies and retain independence in activities of daily living.
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Chris R
authors.initials: CR
authors.lastname: Mellano
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Noam
authors.initials: N
authors.lastname: Kupfer
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Thorsness
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Peter N
authors.initials: PN
authors.lastname: Chalmers
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Terrence F
authors.initials: TF
authors.lastname: Feldheim
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: O'Donnell
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Cole
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Nikhil N
authors.initials: NN
authors.lastname: Verma
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Romeo
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA. Electronic address: gregory.nicholson@rushortho.com.
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Nicholson
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000072228:Arthroplasty, Replacement, Shoulder / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010003:Osteoarthritis / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology*; D012086:Reoperation; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
keywords: Reverse total shoulder arthroplasty; activities of daily living; bilateral; hygiene; rotator cuff tear arthropathy; shoulder replacement