Medical College of Wisconsin
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Resection arthroplasty for failed shoulder arthroplasty. J Shoulder Elbow Surg 2013 Feb;22(2):247-52

Date

09/04/2012

Pubmed ID

22938790

DOI

10.1016/j.jse.2012.05.025

Scopus ID

2-s2.0-84872684951 (requires institutional sign-in at Scopus site)   36 Citations

Abstract

BACKGROUND: As shoulder arthroplasty becomes more common, the number of failed arthroplasties requiring revision is expected to increase. When revision arthroplasty is not feasible, resection arthroplasty has been used in an attempt to restore function and relieve pain. Although outcomes data for resection arthroplasty exist, studies comparing the outcomes after the removal of different primary shoulder arthroplasties have been limited.

MATERIALS AND METHODS: This was a retrospective multicenter review of 26 patients who underwent resection arthroplasty for failure of a primary arthroplasty at a mean follow-up of 41.8 months (range, 12-130 months). Resection arthroplasty was performed for 6 failed total shoulder arthroplasties (TSAs), 7 failed hemiarthroplasties, and 13 failed reverse TSAs.

RESULTS: Patients who underwent resection arthroplasty demonstrated significant improvement in visual analog scale pain score (6 ± 4 preoperatively to 3 ± 2 postoperatively). Mean active forward flexion and mean active external rotation decreased, but this difference was not significant. Subgroup analysis revealed that postoperative mean active forward flexion was significantly greater in patients undergoing resection arthroplasty after failed TSA than after reverse TSA (P = .01).

CONCLUSIONS: Resection arthroplasty is effective in relieving pain, but patients have poor postoperative function. Patients with resection arthroplasty for failed reverse shoulder arthroplasty have worse function than those with failed hemiarthroplasty or TSA. Surgeons should be aware of this when assessing postoperative function. There is no difference in functional outcome between hemiarthroplasty and TSA.

Author List

Muh SJ, Streit JJ, Lenarz CJ, McCrum C, Wanner JP, Shishani Y, Moraga C, Nowinski RJ, Edwards TB, Warner JJ, Walch G, Gobezie R

Author

John P. Wanner MD Assistant Professor in the Orthopaedic Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Arthroplasty, Replacement
Device Removal
Female
Humans
Male
Middle Aged
Prosthesis Failure
Recovery of Function
Reoperation
Retrospective Studies
Shoulder Joint
Shoulder Pain