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Patient Outcomes After Revision of Anatomic Total Shoulder Arthroplasty to Reverse Shoulder Arthroplasty for Rotator Cuff Failure or Component Loosening

A Matched Cohort Study

Shields, Edward, MD; Wiater, J. Michael, MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: February 15, 2019 - Volume 27 - Issue 4 - p e193–e198
doi: 10.5435/JAAOS-D-17-00350
Research Article

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

From The Department of Orthopaedic Surgery, Beaumont Health, Royal Oak, MI.

Correspondence to Dr. Wiater:

Dr. Wiater or an immediate family member has received royalties from Smith & Nephew; is a member of a speakers' bureau or has made paid presentations on behalf of DePuy Synthes and Zimmer Biomet; has stock or stock options held in Catalyst OrthoScience, Hoolux Medical, and Mpirik; has received research or institutional support from Zimmer Biomet, DJO Global, and Tornier; and serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons and the American Shoulder and Elbow Surgeons. Neither Dr. Shields nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article.

© 2019 by American Academy of Orthopaedic Surgeons
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