Failure of Anatomic Total Shoulder Arthroplasty with Revision to Another Anatomic Total Shoulder Arthroplasty

Document Type : RESEARCH PAPER

Authors

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

2 Rothman Institute, Thomas Jefferson University Hospitals, Philadelphia, PA, USA

3 Department of Orthopaedic Surgery, Thomas Jefferson University Hospitals, Philadelphia, PA, USA

Abstract

Background: While outcomes of primary anatomic total shoulder arthroplasty (aTSA) are generally favorable, results
after revision procedures are less reliable. This study examines the functional outcomes, complications, and implant
survival in patients who underwent revision of aTSA to aTSA.
Methods: Patients who underwent revision aTSA were identified from 2008-2015. Demographic, clinical, surgical,
and outcomes data were analyzed. Patient-reported outcomes including the American Shoulder and Elbow Surgeons
Score (ASES), Single Assessment Numerical Evaluation (SANE), Visual Analog Scale for pain (VAS), the Short Form-
12 Health Survey (SF-12), and patient satisfaction were recorded.
Results: Twenty patients underwent revision from a primary aTSA to aTSA (55% male, 62.0±6.8 years-old). Revision
aTSA occurred at 2.5±3.4 years after index surgery. Seven (35%) required future revision at 1.8±1.9 years after revision
aTSA. Among the 13 patients who did not undergo revision, twelve (92.3%) had over two-year follow-up (4.0±2.4
years). Average ASES score was 70.1±23.5, SANE 66.0±29.4, VAS 2.7±3.0, SF-12 Mental 52.4±10.5, SF-12 Physical
36.8±8.9, and satisfaction of 3.6±1.2.
Conclusion: Results of revision aTSA to aTSA were unpredictable and the revision rate was high. The cases that do
not undergo revision had satisfactory, but inconsistent functional results. Reverse arthroplasty may be more reliable in
this patient population.
Level of evidence: IV

Keywords

Main Subjects

References

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The Archives of Bone and Joint Surgery
Volume 7, Issue 1
January and February 2019
Pages 19-23

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History

  • Receive Date: 16 September 2018
  • Accept Date: 14 October 2018

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