Revision of Anatomic Total Shoulder Arthroplasty to Hemiarthroplasty: Does it work? 2020

Mihir Sheth, and Daniel Sholder, and Joseph Abboud, and Mark Lazarus, and Gerald Williams, and Surena Namdari
Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.

BACKGROUND The projected increase in revision shoulder arthroplasty has increased interest in the outcomes of these procedures. Glenoid component removal and conversion to a hemiarthroplasty (HA) is an option for aseptic glenoid loosening after anatomic total shoulder arthroplasty (aTSA). METHODS We identified patients who had undergone revision shoulder arthroplasty over a 15-year period. 17 patients met inclusion and exclusion criteria, and a retrospective chart review was conducted for pre-surgical and operative data. We contacted patients at a mean follow-up of 70 months from revision surgery for implant survival, reoperations and functional outcomes scores. RESULTS Implant survival was estimated to be 88% at 2 years and 67% at 5 years. Mean ASES score for surviving implants was 58 ± 22. Mean SANE score was 54 ± 24, and mean VAS pain score was 3.5 ± 2.8. Mean SF-12 Mental and Physical scores were 46 ± 15 and 38 ± 10, respectively. Five patients (50% of those with surviving implants) reported being either very satisfied or satisfied with the status of their shoulder. There were complications in 6 patients (35%) and 5 patients (29%) required reoperation. CONCLUSIONS HA following failed aTSA due to glenoid loosening produced modest clinical results and satisfaction rates. Reverse arthroplasty may be a more reliable treatment strategy in this patient population.

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