Revision of Anatomic Total Shoulder Arthroplasty to Hemiarthroplasty: Does it work?

Document Type: RESEARCH PAPER

Authors

1 Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA

2 Rothman Institute, Thomas Jefferson University, Department of Orthopaedic Surgery, Philadelphia, PA, USA

Abstract

Background: The projected increase in revision shoulder arthroplasty has increased interest in the outcomes of these
procedures. Glenoid component removal and conversion to a hemiarthroplasty (HA) is an option for aseptic glenoid
loosening after anatomic total shoulder arthroplasty (aTSA).
Methods: We identified patients who had undergone revision shoulder arthroplasty over a 15-year period. 17 patients
met inclusion and exclusion criteria, and a retrospective chart review was conducted for pre-surgical and operative
data. We contacted patients at a mean follow-up of 70 months from revision surgery for implant survival, reoperations
and functional outcomes scores.
Results: Implant survival was estimated to be 88% at 2 years and 67% at 5 years. Mean ASES score for surviving
implants was 58 ± 22. Mean SANE score was 54 ± 24, and mean VAS pain score was 3.5 ± 2.8. Mean SF-12 Mental
and Physical scores were 46 ± 15 and 38 ± 10, respectively. Five patients (50% of those with surviving implants)
reported being either very satisfied or satisfied with the status of their shoulder. There were complications in 6 patients
(35%) and 5 patients (29%) required reoperation.
Conclusion: HA following failed aTSA due to glenoid loosening produced modest clinical results and satisfaction rates.
Reverse arthroplasty may be a more reliable treatment strategy in this patient population.
Level of evidence: IV

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