Boileau P
Department of Orthopedic and Sports Surgery, Pasteur 2 Hospital, University Institute of Locomotion and Sports (IULS), 30, voie Romaine, 06000 Nice, France.
Orthop Traumatol Surg Res. 2016 Feb;102(1 Suppl):S33-43. doi: 10.1016/j.otsr.2015.06.031. Epub 2016 Feb 12.
The most common causes of revision surgery after reverse total shoulder arthroplasty (RTSA) are, in decreasing order: prosthetic instability (38%), infection (22%), humeral problems (21%) including loosening, unscrewing and fracture, and, lastly, problems of glenoid loosening (13%). Complications leading to reoperation are often multiple and their association is underestimated. It is not uncommon for patients to be reoperated several times due to the persistence of the same complication, failure to diagnose associated complications, or onset of an additional complication. Although it may require a number of procedures in the same patient, it is very often possible (in 90% of cases, in our experience) to conserve or replace the RTSA, allowing patients to recover a functional shoulder. However, the functional results of revised RTSA are inferior than for primary prostheses, and depend on the surgeon's experience and the number of RTSAs performed, suggesting that patients should be referred to a tertiary center.
全肩关节置换术（RTSA）翻修手术最常见的原因，按发生率递减顺序依次为：假体不稳定（38%）、感染（22%）、肱骨问题（21%），包括松动、拧松和骨折，最后是肩胛盂松动问题（13%）。导致再次手术的并发症往往是多种的，其关联性被低估。由于同一并发症持续存在、未能诊断出相关并发症或出现额外并发症，患者多次接受再次手术的情况并不少见。尽管在同一患者身上可能需要进行多次手术，但通常（根据我们的经验，90%的病例）可以保留或更换RTSA，使患者恢复有功能的肩部。然而，翻修后的RTSA功能结果不如初次假体，且取决于外科医生的经验和所进行的RTSA手术数量，这表明患者应被转诊至三级中心。
