Reversed revised: what to do when it goes wrong ?
- Author
- BART MIDDERNACHT (UGent) , Alexander Van Tongel (UGent) and Lieven De Wilde (UGent)
- 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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Citation
Please use this url to cite or link to this publication: http://hdl.handle.net/1854/LU-5780526
- 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}}, }