Thursday, November 8, 2018

Reverse total shoulder - complications and revisions

Risk and risk factors for revision after primary reverse shoulder arthroplasty for cuff tear arthropathy and osteoarthritis: a Nordic Arthroplasty Register Association study

These authors identified patients with cuff tear arthropathy or osteoarthritis were identified from the Nordic Arthroplasty Register Association registry data (2004-2013).

The study included 1904 patients with RSA  (69% women; mean age, 74 years; age range, 35-97 years). 

Revision was performed in 95 patients (5%), with a 10-year cumulative revision rate of 0.91. The most common reason for revision was infection (n = 42), followed by loosening (n = 16) and instability (n = 12).
 Most revisions occurred less than 6 months after the primary operation. Men had a significantly increased risk of revision compared with women (risk ratio, 3.8; 95% confidence interval, 2.4-6.1). In the survivorship graph below, women are represented by the upper line.

The most common implants were the Delta Xtend (n = 1366) and Delta Mark III (n = 246). The risk of revision of the Delta Mark III was 2.1 (95% confidence interval, 1.1-4.3) compared with the Delta Xtend. In the survivorship graph below, the Delta Xtend is represented by the upper line.

Comment:  It is of interest that the distribution of complications requiring revision in this study is different from that reported in a recent review of the literature and among the cases reported to the FDA (see this link):

We have a new set of shoulder youtubes about the shoulder, check them out at this link.

Be sure to visit "Ream and Run - the state of the art" regarding this radically conservative approach to shoulder arthritis at this link and this link

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