This article is based on a review of registry data of 68 revisions for prior humeral hemiarthroplasty performed between 1981 and 2005 by an individual highly experienced shoulder arthroplasty surgeon. The revision procedures included bone grafts, rotator cuff reconstruction, soft tissue releases, and insertion of a glenoid component.
The major point is that even in excellent hands, these revisions are challenging: 38 of 68 cases were rated as 'unsatisfactory' by Neer rating. The low ratings were due to persistent pain, stiffness, instability, and patient dissatisfaction. Fifteen shoulders (22%) required re-revision for instability, infection, osteolysis/loosening, subscapularis failure, pain, and broken wires and screws.
There is no description of the authors' protocol for excluding low grade infection.
Reverse total shoulder was not used in this series of cases.
No preoperative or intraoperative factors could be identified that predicted the quality of the outcome.
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