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Reversed revised: what to do when it goes wrong ?

BART MIDDERNACHT (UGent) , Alexander Van Tongel (UGent) and Lieven De Wilde (UGent)
(2014) ACTA ORTHOPAEDICA BELGICA. 80(3). p.314-321
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Organization
Abstract
Reversed total shoulder arthroplasty (RTSA) has well known indications and good to excellent results are described in the literature. When the arthroplasty fails however, revision remains a technical challenge with many questions unanswered. To analyse retrospectively and consecutively the indications and results of primary RTSA-revision. All patients that underwent revision RTSA between 2004 and 2009 were included. Indications for surgery, surgical details and clinical evaluation with the pre- and postoperative Constant-score (CS) were analyzed. 37 Revisions (37 patients) of RTSA were analysed with an average follow up of 41.2 months (24-84). Indications were infection (23), glenoid loosening (9), instability (2) malpositioning (2) and suprascapular nerve irritation (1). 25 patients obtained a one-stage conversion to a new reversed prosthesis; 4 patients obtained a two-stage revision; 8 patients got a mega-head prosthesis. No difference in reinfection rate is seen between one- and two stage techniques. An overall lower CS is seen for the mega-head prosthesis. Conclusions : The main indication for revision was infection. Revision of RTSA to a new reversed prosthesis is to prefer even when several procedures are necessary in one patient. When this is impossible, a mega-head prosthesis is to consider and gives reasonable results.
Keywords
complications, infection, revision, Reversed, total shoulder prosthesis, TOTAL SHOULDER ARTHROPLASTY, REPLACEMENT, FAILURE, malpositioning, dislocation

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Please use this url to cite or link to this publication:

MLA
MIDDERNACHT, BART, et al. “Reversed Revised: What to Do When It Goes Wrong ?” ACTA ORTHOPAEDICA BELGICA, vol. 80, no. 3, 2014, pp. 314–21.
APA
MIDDERNACHT, B., Van Tongel, A., & De Wilde, L. (2014). Reversed revised: what to do when it goes wrong ? ACTA ORTHOPAEDICA BELGICA, 80(3), 314–321.
Chicago author-date
MIDDERNACHT, BART, Alexander Van Tongel, and Lieven De Wilde. 2014. “Reversed Revised: What to Do When It Goes Wrong ?” ACTA ORTHOPAEDICA BELGICA 80 (3): 314–21.
Chicago author-date (all authors)
MIDDERNACHT, BART, Alexander Van Tongel, and Lieven De Wilde. 2014. “Reversed Revised: What to Do When It Goes Wrong ?” ACTA ORTHOPAEDICA BELGICA 80 (3): 314–321.
Vancouver
1.
MIDDERNACHT B, Van Tongel A, De Wilde L. Reversed revised: what to do when it goes wrong ? ACTA ORTHOPAEDICA BELGICA. 2014;80(3):314–21.
IEEE
[1]
B. MIDDERNACHT, A. Van Tongel, and L. De Wilde, “Reversed revised: what to do when it goes wrong ?,” ACTA ORTHOPAEDICA BELGICA, vol. 80, no. 3, pp. 314–321, 2014.
@article{5780526,
  abstract     = {{Reversed total shoulder arthroplasty (RTSA) has well known indications and good to excellent results are described in the literature. When the arthroplasty fails however, revision remains a technical challenge with many questions unanswered. 
To analyse retrospectively and consecutively the indications and results of primary RTSA-revision. 
All patients that underwent revision RTSA between 2004 and 2009 were included. Indications for surgery, surgical details and clinical evaluation with the pre- and postoperative Constant-score (CS) were analyzed. 37 Revisions (37 patients) of RTSA were analysed with an average follow up of 41.2 months (24-84). Indications were infection (23), glenoid loosening (9), instability (2) malpositioning (2) and suprascapular nerve irritation (1). 25 patients obtained a one-stage conversion to a new reversed prosthesis; 4 patients obtained a two-stage revision; 8 patients got a mega-head prosthesis. No difference in reinfection rate is seen between one- and two stage techniques. An overall lower CS is seen for the mega-head prosthesis. 
Conclusions : The main indication for revision was infection. Revision of RTSA to a new reversed prosthesis is to prefer even when several procedures are necessary in one patient. When this is impossible, a mega-head prosthesis is to consider and gives reasonable results.}},
  author       = {{MIDDERNACHT, BART and Van Tongel, Alexander and De Wilde, Lieven}},
  issn         = {{0001-6462}},
  journal      = {{ACTA ORTHOPAEDICA BELGICA}},
  keywords     = {{complications,infection,revision,Reversed,total shoulder prosthesis,TOTAL SHOULDER ARTHROPLASTY,REPLACEMENT,FAILURE,malpositioning,dislocation}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{314--321}},
  title        = {{Reversed revised: what to do when it goes wrong ?}},
  volume       = {{80}},
  year         = {{2014}},
}

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