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

Document Type: RESEARCH PAPER

Authors

1 925 Chestnut St 5th Floor

2 Sidney Kimmel Medical College at Thomas Jefferson University

3 The Rothman Institute

4 Rothman Institute- Thomas Jefferson University, Department of Orthopaedic Surgery

Abstract

Introduction: The impending burden of revision shoulder arthroplasty has increased interest in
outcomes of revision procedures. Glenoid component removal and conversion to a
hemiarthroplasty (HA) is an option for aseptic glenoid loosening after anatomic total shoulder
arthroplasty (aTSA).

Methods: Patients who underwent revision shoulder arthroplasty over a 15-year period were
identified. Pre-surgical and operative data were analyzed for 17 patients who met inclusion and
exclusion criteria. Patients were contacted at a mean follow-up of 70 months from revision
surgery for functional outcomes scores, reoperations, and implant survival.

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 satisfied or very satisfied with the status of their shoulder. Complications were seen in 6 patients (35%) and 5 patients (29%) required reoperation.

Conclusions: 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.

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