Problems, complications, reoperations, and revisions in reverse total shoulder arthroplasty: A systematic review
Matthias A. Zumstein, Miguel Pinedo, Jason Old, Pascal Boileau
The use of hemiarthroplasty in patients with an arthritic rotator cuff deficient shoulder has been shown to provide limited function and inconsistent pain relief.
The semiconstrained reverse shoulder prosthesis, designed by Grammont in the late 1980s, was invented based on 2 biomechanical concepts: lowering the humerus and medialization of the center of rotation at the glenoid component. This design has the dual advantage of tensioning the deltoid muscle to increase its functional strength, and decreasing mechanical torque at the glenoid component, thus avoiding glenoid loosening. The first series of reverse shoulder arthroplasty (RSA) with at least 2 years of follow-up confirmed the preliminary results, with excellent functional outcome and stable glenoid fixation. However, these series had a small numbers of patients and reported variable compli-cation and revision rates of 15% to 50% and reoperation rates of 4% to 40%. One reason for the high variability was unclear definitions of complications and revisions, which varied markedly between the series. Furthermore, it is difficult to draw conclusions from small numbers of patients.
The purpose of the present study was to determine the incidence and functional significance of adverse events after RSA, including problems, complications, reopera-tions, and revisions. We established a study design and specific objectives before commencing the literature research. These objectives were (1) to perform a systematic review of the published literature to determine the overall rates of problems, complications, reoperations, and revi-sions after RSA; (2) to compare their influence on the final functional outcome; and, (3) to analyze the different problems, complications, reoperations, and revisions based on the etiology of the RSA
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