Patient Outcomes After Revision of Anatomic Total Shoulder Arthroplasty to Reverse Shoulder Arthroplasty for Rotator Cuff Failure or Component Loosening: A Matched Cohort Study

J Am Acad Orthop Surg. 2019 Feb 15;27(4):e193-e198. doi: 10.5435/JAAOS-D-17-00350.

Abstract

Purpose: To compare outcomes after conversion of anatomic total shoulder arthroplasty (aTSA) to reverse total shoulder arthroplasty (RTSA) and a matched cohort.

Methods: Patients converted from aTSA to RTSA for rotator cuff failure or component loosening and a primary RTSA matched cohort were retrospectively identified from a prospective database. Demographics and preoperative and postoperative outcomes were obtained and compared.

Results: Age, sex, body mass index, follow-up length, and preoperative function were similar between revision (n = 35) and primary (n = 70) groups. At final follow-up, visual analog scale pain (2.4 ± 2.8 versus 1.7 ± 2.8; P = 0.24) and American Shoulder and Elbow Surgeons (68 ± 26 versus 76 ± 24; P = 0.14) scores were similar. The revision group had worse subjective shoulder value scores (63 ± 30 versus 79 ± 21; P = 0.002), satisfaction (74% versus 90%; P = 0.03), and more complications (31% versus 13%; P = 0.02).

Conclusion: Revision of aTSA to RTSA for component loosening or rotator cuff failure results in function comparable to primary RTSA; however, more complications, worse subjective shoulder value scores, and lower patient satisfaction should be expected.

Level of evidence: Level III, retrospective comparative.

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Shoulder / methods*
  • Arthroplasty, Replacement, Shoulder / psychology
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain
  • Patient Satisfaction
  • Prosthesis Failure*
  • Reoperation* / psychology
  • Retrospective Studies
  • Rotator Cuff / physiopathology
  • Rotator Cuff / surgery*
  • Rotator Cuff Injuries / physiopathology
  • Rotator Cuff Injuries / surgery*
  • Shoulder Joint / physiopathology
  • Shoulder Joint / surgery*
  • Treatment Outcome