Use of the reverse shoulder prosthesis for the treatment of failed hemiarthroplasty in patients with glenohumeral arthritis and rotator cuff deficiency

• Published in: Journal of bone and joint surgery. British volume Vol. 89; no. 2; pp. 189 - 195
• Main Authors: LEVY, J. C, VIRANI, N, PUPELLO, D, FRANKLE, M
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01-02-2007; British Editorial Society of Bone & Joint Surgery
• Edition: British volume
• Subjects: Aged; Aged, 80 and over; Arthritis - surgery; Arthroplasty, Replacement - adverse effects; Arthroplasty, Replacement - methods; Biological and medical sciences; Diseases of the osteoarticular system; Female; Follow-Up Studies; Humans; Joint Prosthesis - adverse effects; Male; Medical sciences; Middle Aged; Miscellaneous. Osteoarticular involvement in other diseases; Orthopedic surgery; Osteoporosis. Osteomalacia. Paget disease; Pain Measurement - methods; Prosthesis Design; Prosthesis Failure; Radiography; Range of Motion, Articular; Recovery of Function; Reoperation - methods; Rotator Cuff - physiopathology; Shoulder Joint - diagnostic imaging; Shoulder Joint - physiopathology; Shoulder Joint - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome; Human; Deficiency; Diseases of the osteoarticular system; Arthritis; Reverse prosthesis; Orthopedic surgery; Pain; Treatment; Glenoid cavity; Glenohumeral joint; Shoulder; Orthopedics; Hemiarthroplasty; Humerus; Rotator cuff; Osteopenia
• ISSN: 0301-620X; 2049-4394; 2044-5377; 2049-4408
• DOI: 10.1302/0301-620X.89B2.18161

We report the use of the reverse shoulder prosthesis in the revision of a failed shoulder hemiarthroplasty in 19 shoulders in 18 patients (7 men, 11 women) with severe pain and loss of function. The primary procedure had been undertaken for glenohumeral arthritis associated with severe rotator cuff deficiency. Statistically significant improvements were seen in pain and functional outcome. After a mean follow-up of 44 months (24 to 89), mean forward flexion improved by 26.4 degrees and mean abduction improved by 35 degrees . There were six prosthesis-related complications in six shoulders (32%), five of which had severe bone loss of the glenoid, proximal humerus or both. Three shoulders (16%) had non-prosthesis related complications. The use of the reverse shoulder prosthesis provides improvement in pain and function for patients with failure of a hemiarthroplasty for glenohumeral arthritis and rotator cuff deficiency. However, high rates of complications were associated with glenoid and proximal humeral bone loss.