Holschen M, Franetzki B, Witt K-A, Liem D, Steinbeck J
Orthopedic Practice Clinic (OPPK), Von-Vincke-Str. 14, 48143, Münster, Germany.
Orthopedic Department of the University of Münster, Münster, Germany.
Musculoskelet Surg. 2017 Aug;101(2):173-180. doi: 10.1007/s12306-017-0467-y. Epub 2017 Feb 15.
Is reverse total shoulder arthroplasty a feasible treatment option for failed shoulder arthroplasty? A retrospective study of 44 cases with special regards to stemless and stemmed primary implants.
Due to humeral or glenoid bone-loss and rotator cuff insufficiency reverse total shoulder arthroplasty often means the only remaining treatment option in revision shoulder arthroplasty. This study investigates the clinical outcome of patients treated with a reverse total shoulder in revision cases with special regard to stemless and stemmed primary implants.
From 2010 to 2012 60 failed shoulder arthroplasties were converted to reverse total shoulder arthroplasty. Forty-four patients were available for follow-up after a mean of 24 months. Patients were assessed with X-rays, Constant- and ASES Score and a questionnaire about their subjective satisfaction.
The total number of observed complications was seven (16%). Ninety-eight percent of the patients were satisfied with their clinical result. Patients achieved a mean normalized constant score of 70.2% and a mean ASES Score of 65.3. Patients with stemless primary implants achieved a higher normalized constant score than patients with stemmed primary implants (82 vs. 61.8%; p = 0009).
Reverse total shoulder arthroplasty provides satisfactory clinical results and a high patient satisfaction in revision shoulder arthroplasty. The complication rate needs to be considered and discussed with the patient prior to surgery. Presence or absence of a stem of revised shoulder arthroplasties interferes with the outcome. LEVEL OF EVIDENCE IV: (Retrospective study).
翻修全肩关节置换术对于失败的肩关节置换术而言是一种可行的治疗选择吗？一项针对44例病例的回顾性研究，特别关注无柄和有柄初次植入物。
由于肱骨或肩胛盂骨丢失以及肩袖功能不全，翻修全肩关节置换术通常是翻修肩关节置换术中唯一剩下的治疗选择。本研究调查了在翻修病例中接受翻修全肩关节置换术治疗的患者的临床结果，特别关注无柄和有柄初次植入物。
2010年至2012年，60例失败的肩关节置换术被转换为翻修全肩关节置换术。44例患者在平均24个月后可供随访。通过X线、Constant评分和ASES评分以及一份关于主观满意度的问卷对患者进行评估。
观察到的并发症总数为7例（16%）。98%的患者对其临床结果满意。患者的平均标准化Constant评分为70.2%，平均ASES评分为65.3。使用无柄初次植入物的患者比使用有柄初次植入物的患者获得更高的标准化Constant评分（82%对61.8%；p = 0.009）。
翻修全肩关节置换术在翻修肩关节置换术中提供了令人满意的临床结果和较高的患者满意度。并发症发生率在手术前需要与患者进行考虑和讨论。翻修肩关节置换术有无柄对结果有影响。证据级别IV：（回顾性研究）
