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High complication, reoperation rates seen revising reverse shoulder arthroplasty

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SAN FRANCISCO — Upper extremity surgeons have a few options when they need to revise a reverse total shoulder arthroplasty procedure, but should expect increased complication and reoperation rates in these cases, according to a surgeon speaking here.

However, according to Galen Kam, MD, the rates are comparable to those reported for revisions of total shoulder arthroplasties by other surgeons and in the literature.

During a presentation at the American Academy of Orthopaedic Surgeons 75th Annual Meeting, he said, "To date, this is the largest review of reverse shoulder revision surgeries. The revision of a reverse prosthesis has a high complication rate and a reoperation rate of about 42% and 46% respectively."

Kam, of Kailua, Hawaii, and two colleagues retrospectively analyzed results revising 25 patients primarily treated with 26 reverse shoulder prostheses (Aequalis Reversed Shoulder; Tornier). Glenosphere loosening was the main reason for revision (seven), along with infection (five) and instability (two).

Resection arthroplasty was used in most cases (19%) and about 4% of patients needed glenohumeral fusions.

The study was limited by the small sample size of 25 patients who were followed only for about 12 months. Furthermore, because these patients may represent a population that is already predisposed to complications, these data could be somewhat skewed, Kam said.

For more information:

• Kam G, Norris TR, Kelly JD. Early results following revision of reversed total shoulder arthroplasty. #2. Presented at the American Academy of Orthopaedic Surgeons 75th Annual Meeting. March 5-9, 2008. San Francisco.