title: Is reverse total shoulder arthroplasty a feasible treatment option for failed shoulder arthroplasty? A retrospective study of 44 cases with special regards to stemless and stemmed primary implants.
abstract: Is reverse total shoulder arthroplasty a feasible treatment option for failed shoulder arthroplasty? A retrospective study of 44 cases with special regards to stemless and stemmed primary implants.
  
  
  BACKGROUND
  Due to humeral or glenoid bone-loss and rotator cuff insufficiency reverse total shoulder arthroplasty often means the only remaining treatment option in revision shoulder arthroplasty. This study investigates the clinical outcome of patients treated with a reverse total shoulder in revision cases with special regard to stemless and stemmed primary implants.
  
  
  METHODS
  From 2010 to 2012 60 failed shoulder arthroplasties were converted to reverse total shoulder arthroplasty. Forty-four patients were available for follow-up after a mean of 24 months. Patients were assessed with X-rays, Constant- and ASES Score and a questionnaire about their subjective satisfaction.
  
  
  RESULTS
  The total number of observed complications was seven (16%). Ninety-eight percent of the patients were satisfied with their clinical result. Patients achieved a mean normalized constant score of 70.2% and a mean ASES Score of 65.3. Patients with stemless primary implants achieved a higher normalized constant score than patients with stemmed primary implants (82 vs. 61.8%; p = 0009).
  
  
  CONCLUSIONS
  Reverse total shoulder arthroplasty provides satisfactory clinical results and a high patient satisfaction in revision shoulder arthroplasty. The complication rate needs to be considered and discussed with the patient prior to surgery. Presence or absence of a stem of revised shoulder arthroplasties interferes with the outcome. LEVEL OF EVIDENCE IV: (Retrospective study).
authors.affiliation: Orthopedic Practice Clinic (OPPK), Von-Vincke-Str. 14, 48143, Münster, Germany. holmal@web.de.
authors.forename: M
authors.initials: M
authors.lastname: Holschen
authors.affiliation: Orthopedic Practice Clinic (OPPK), Von-Vincke-Str. 14, 48143, Münster, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Franetzki
authors.affiliation: Orthopedic Practice Clinic (OPPK), Von-Vincke-Str. 14, 48143, Münster, Germany.
authors.forename: K-A
authors.initials: KA
authors.lastname: Witt
authors.affiliation: Orthopedic Department of the University of Münster, Münster, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Liem
authors.affiliation: Orthopedic Practice Clinic (OPPK), Von-Vincke-Str. 14, 48143, Münster, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Steinbeck
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001178:Arthroplasty; D000072228:Arthroplasty, Replacement, Shoulder / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D012189:Retrospective Studies; D000072227:Shoulder Prosthesis; D017211:Treatment Failure
keywords: Aseptic loosening; Failed shoulder arthroplasty; Reverse total shoulder arthroplasty; Revision shoulder arthroplasty; Rotator cuff insufficiency; Scapular notching