These authors reviewed 76 reverse shoulder arthroplasties (RSA) for cuff tear arthropathy (45 patients), fracture sequelae (10 patients) and revision arthroplasty (21 patients) with a mean follow-up period of 23 months (±14 months).
Patients with cuff tear arthropathy (CTA) showed a higher Constant Score (CS) of 83 % compared with patients with fracture sequelae (CS 73 %) and compared with patients who had undergone RSA as a revision for failed shoulder arthroplasty (CS 69 %).
Within the group of fracture sequelae, patients with type three sequelae according to the Boileau classification (surgical neck nonunion) had a significantly worse outcome compared with the type four fracture sequelae patients (severe tuberosity dislocation) (CS 57 vs. 87 %, p = 0.01).
The overall complication rate was 27 % with 8 % infections and 9 % dislocations. Revision surgery was necessary in 11.5 % with removal or replacement of the implants in 8 %. Inferior scapular notching was detected in 43 % of the patients. These patients had an inferior CS (70 ± 18 %) compared with patients without scapular notching (84 ± 25 %, p = 0.015).
The incidence of scapular notching was significantly reduced with an increasing inferior overlap of the glenosphere.
Clearly this is a high stakes operation and we will have the opportunity to see an increasing number of complications and revisions as this procedure is being performed at an increasing rate.
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