Functional Outcomes and a Review of Management Options for Revision Shoulder Arthroplasty
https://doi.org/10.5704/MOJ.2407.003
- Author:
Rai AK
1
;
Kumar K
1
Author Information
1. Department of Orthopaedics, Woodend Hospital, Aberdeen, United Kingdom
- Publication Type:Journal Article
- Keywords:
total shoulder replacements, shoulder revision surgery, outcomes, management
- From:Malaysian Orthopaedic Journal
2024;18(No.2):18-26
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Increase in the number of primary shoulder
arthroplasty has led to an increase in the number of revisions
which presents many complex challenges and often has
inferior outcomes.
Materials and methods: Data was collected retrospectively,
and patients were classified using Dines classification.
Comprehensive case reviews were done to identify preoperative and intra-operative challenges. The primary
outcome measure was Oxford shoulder score (OSS). The
secondary measures were range of motion (ROM) and
patient satisfaction (very satisfied, satisfied, not satisfied or
worse).
Results: A total of 32 patients were identified with a mean
age of 67.64 years and the most common cause of revision
was a combination of bone and soft tissue failure (39.3%).
All patients (n=8) with hemiarthroplasty had rotator cuff
deficiency while patients with resurfacing had both rotator
cuff failure and bony erosion. Four patients needed a
proximal humeral osteotomy and six patients needed
allograft reconstruction of the glenoid for bone loss. Twentyone shoulders were revised to reverse total shoulder
arthroplasty (TSA), 2 to anatomical TSA and 5 were left with
cement spacer in situ. Mean duration of follow-up was 41.6
months. Mean OSS at the last follow-up was 26.88 with
statistically significant improvement in ROM. There was no
statistical difference in clinical outcomes (p>0.05) based on
the type of primary prosthesis or cause of revision. A total of
70% patients were pain free. Patients with infection had
inferior outcomes with a mean OSS of 17.
Conclusion: Management of patients with failed shoulder
arthroplasty is often challenging but has good clinical
outcome except in infections.
- Full text:202408201657351899316.2024my1368.pdf
