Skip to main content
Top
Published in: Clinical Orthopaedics and Related Research® 1/2009

01-01-2009 | Original Article

Reverse Total Shoulder Replacement: Intraoperative and Early Postoperative Complications

Authors: Carl Wierks, MD, Richard L. Skolasky, ScD, Jong Hun Ji, MD, Edward G. McFarland, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 1/2009

Login to get access

Abstract

Reverse total shoulder arthroplasty is a treatment option for patients with symptomatic glenohumeral arthritis and a deficient rotator cuff. The reported complication rates vary from 0% to 68%. Given this variation, our purposes were to (1) determine the learning curve for the procedure, (2) identify complications and surgical pitfalls, and (3) compare our results with those of similar published series. We retrospectively reviewed 20 consecutive patients (mean age, 73 years; range, 45–88 years) who had reverse total shoulder arthroplasty by one surgeon, tabulating intraoperative and postoperative complications. Minimum followup was 3 months (average, 9 months; range, 3–21 months). The intraoperative complication rate for the first 10 patients was higher than that for the second 10 patients. There were 33 complications in 15 patients: 11 patients collectively had 22 intraoperative complications and eight patients collectively had 11 postoperative complications. At radiographic followup, 11 patients had scapular notching and nine patients had heterotopic ossification. Our complication rate was higher than published rates.
Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
Literature
1.
go back to reference Boileau P, Watkinson DJ, Hatzidakis AM, Balg F. Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elbow Surg. 2005;14(1 suppl S):147S–161S.PubMedCrossRef Boileau P, Watkinson DJ, Hatzidakis AM, Balg F. Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elbow Surg. 2005;14(1 suppl S):147S–161S.PubMedCrossRef
2.
go back to reference Boulahia A, Edwards TB, Walch G, Baratta RV. Early results of a reverse design prosthesis in the treatment of arthritis of the shoulder in elderly patients with a large rotator cuff tear. Orthopedics. 2002;25:129–133.PubMed Boulahia A, Edwards TB, Walch G, Baratta RV. Early results of a reverse design prosthesis in the treatment of arthritis of the shoulder in elderly patients with a large rotator cuff tear. Orthopedics. 2002;25:129–133.PubMed
3.
go back to reference Cook JA, Ramsay CR, Fayers P. Using the literature to quantify the learning curve: a case study. Int J Technol Assess Health Care. 2007;23:255–260.PubMedCrossRef Cook JA, Ramsay CR, Fayers P. Using the literature to quantify the learning curve: a case study. Int J Technol Assess Health Care. 2007;23:255–260.PubMedCrossRef
4.
go back to reference De Wilde L, Sys G, Julien Y, Van Ovost E, Poffyn B, Trouilloud P. The reversed Delta shoulder prosthesis in reconstruction of the proximal humerus after tumour resection. Acta Orthop Belg. 2003;69:495–500.PubMed De Wilde L, Sys G, Julien Y, Van Ovost E, Poffyn B, Trouilloud P. The reversed Delta shoulder prosthesis in reconstruction of the proximal humerus after tumour resection. Acta Orthop Belg. 2003;69:495–500.PubMed
5.
go back to reference De Wilde LF, Plasschaert FS, Audenaert EA, Verdonk RC. Functional recovery after a reverse prosthesis for reconstruction of the proximal humerus in tumor surgery. Clin Orthop Relat Res. 2005;430:156–162.PubMedCrossRef De Wilde LF, Plasschaert FS, Audenaert EA, Verdonk RC. Functional recovery after a reverse prosthesis for reconstruction of the proximal humerus in tumor surgery. Clin Orthop Relat Res. 2005;430:156–162.PubMedCrossRef
6.
go back to reference Favard L, Lautmann S, Sirveaux F, Oudet D, Kerjean Y, Huguet D. Hemiarthroplasty versus reverse arthroplasty in the treatment of osteoarthritis with massive rotator cuff tear. In: Walch G, Boileau P, Mole D, eds. Shoulder Prosthesis: Two to Ten Year Follow-up. Montpellier, France: Sauramps Medical; 2001:261–268. Favard L, Lautmann S, Sirveaux F, Oudet D, Kerjean Y, Huguet D. Hemiarthroplasty versus reverse arthroplasty in the treatment of osteoarthritis with massive rotator cuff tear. In: Walch G, Boileau P, Mole D, eds. Shoulder Prosthesis: Two to Ten Year Follow-up. Montpellier, France: Sauramps Medical; 2001:261–268.
7.
go back to reference Fleisch MC, Newton J, Steinmetz I, Whitehair J, Hallum A, Hatch KD. Learning and teaching advanced laparoscopic procedures: do alternating trainees impair a laparoscopic surgeon’s learning curve? J Minim Invasive Gynecol. 2007;14:293–299.PubMedCrossRef Fleisch MC, Newton J, Steinmetz I, Whitehair J, Hallum A, Hatch KD. Learning and teaching advanced laparoscopic procedures: do alternating trainees impair a laparoscopic surgeon’s learning curve? J Minim Invasive Gynecol. 2007;14:293–299.PubMedCrossRef
8.
go back to reference Frankle M, Levy JC, Pupello D, Siegal S, Saleem A, Mighell M, Vasey M. The Reverse Shoulder Prosthesis for glenohumeral arthritis associated with severe rotator cuff deficiency: a minimum two-year follow-up study of sixty patients: surgical technique. J Bone Joint Surg Am. 2006;88(suppl 1, pt 2):178–190.PubMedCrossRef Frankle M, Levy JC, Pupello D, Siegal S, Saleem A, Mighell M, Vasey M. The Reverse Shoulder Prosthesis for glenohumeral arthritis associated with severe rotator cuff deficiency: a minimum two-year follow-up study of sixty patients: surgical technique. J Bone Joint Surg Am. 2006;88(suppl 1, pt 2):178–190.PubMedCrossRef
9.
go back to reference Frankle M, Siegal S, Pupello D, Saleem A, Mighell M, Vasey M. The Reverse Shoulder Prosthesis for glenohumeral arthritis associated with severe rotator cuff deficiency: a minimum two-year follow-up study of sixty patients. J Bone Joint Surg Am. 2005;87:1697–1705.PubMedCrossRef Frankle M, Siegal S, Pupello D, Saleem A, Mighell M, Vasey M. The Reverse Shoulder Prosthesis for glenohumeral arthritis associated with severe rotator cuff deficiency: a minimum two-year follow-up study of sixty patients. J Bone Joint Surg Am. 2005;87:1697–1705.PubMedCrossRef
10.
go back to reference Grammont P, Trouilloud P, Laffay JP, Deries X. Etude et réalisation d’une nouvelle prothèse d’épaule. Rheumatologie. 1987;39:407–418. Grammont P, Trouilloud P, Laffay JP, Deries X. Etude et réalisation d’une nouvelle prothèse d’épaule. Rheumatologie. 1987;39:407–418.
11.
go back to reference Grammont PM, Baulot E. Delta shoulder prosthesis for rotator cuff rupture. Orthopedics. 1993;16:65–68.PubMed Grammont PM, Baulot E. Delta shoulder prosthesis for rotator cuff rupture. Orthopedics. 1993;16:65–68.PubMed
12.
go back to reference Guery J, Favard L, Sirveaux F, Oudet D, Mole D, Walch G. Reverse total shoulder arthroplasty: survivorship analysis of eighty replacements followed for five to ten years. J Bone Joint Surg Am. 2006;88:1742–1747.PubMedCrossRef Guery J, Favard L, Sirveaux F, Oudet D, Mole D, Walch G. Reverse total shoulder arthroplasty: survivorship analysis of eighty replacements followed for five to ten years. J Bone Joint Surg Am. 2006;88:1742–1747.PubMedCrossRef
13.
go back to reference Hammond JW, Queale WS, Kim TK, McFarland EG. Surgeon experience and clinical and economic outcomes for shoulder arthroplasty. J Bone Joint Surg Am. 2003;85:2318–2324.PubMed Hammond JW, Queale WS, Kim TK, McFarland EG. Surgeon experience and clinical and economic outcomes for shoulder arthroplasty. J Bone Joint Surg Am. 2003;85:2318–2324.PubMed
14.
go back to reference Jain N, Pietrobon R, Hocker S, Guller U, Shankar A, Higgins LD. The relationship between surgeon and hospital volume and outcomes for shoulder arthroplasty. J Bone Joint Surg Am. 2004;86:496–505.PubMedCrossRef Jain N, Pietrobon R, Hocker S, Guller U, Shankar A, Higgins LD. The relationship between surgeon and hospital volume and outcomes for shoulder arthroplasty. J Bone Joint Surg Am. 2004;86:496–505.PubMedCrossRef
15.
go back to reference Kjaersgaard-Andersen P, Frich LH, Sojbjerg JO, Sneppen O. Heterotopic bone formation following total shoulder arthroplasty. J Arthroplasty. 1989;4:99–104.PubMedCrossRef Kjaersgaard-Andersen P, Frich LH, Sojbjerg JO, Sneppen O. Heterotopic bone formation following total shoulder arthroplasty. J Arthroplasty. 1989;4:99–104.PubMedCrossRef
16.
go back to reference Kreder HJ, Deyo RA, Koepsell T, Swiontkowski MF, Kreuter W. Relationship between the volume of total hip replacements performed by providers and the rates of postoperative complications in the state of Washington. J Bone Joint Surg Am. 1997;79:485–494.PubMed Kreder HJ, Deyo RA, Koepsell T, Swiontkowski MF, Kreuter W. Relationship between the volume of total hip replacements performed by providers and the rates of postoperative complications in the state of Washington. J Bone Joint Surg Am. 1997;79:485–494.PubMed
17.
go back to reference Lavernia CJ. Hemiarthroplasty in hip fracture care: effects of surgical volume on short-term outcome. J Arthroplasty. 1998;13:774–778.PubMedCrossRef Lavernia CJ. Hemiarthroplasty in hip fracture care: effects of surgical volume on short-term outcome. J Arthroplasty. 1998;13:774–778.PubMedCrossRef
18.
go back to reference Lavernia CJ, Guzman JF. Relationship of surgical volume to short-term mortality, morbidity, and hospital charges in arthroplasty. J Arthroplasty. 1995;10:133–140.PubMedCrossRef Lavernia CJ, Guzman JF. Relationship of surgical volume to short-term mortality, morbidity, and hospital charges in arthroplasty. J Arthroplasty. 1995;10:133–140.PubMedCrossRef
19.
go back to reference Levy J, Frankle M, Mighell M, Pupello D. The use of the reverse shoulder prosthesis for the treatment of failed hemiarthroplasty for proximal humeral fracture. J Bone Joint Surg Am. 2007;89:292–300.PubMedCrossRef Levy J, Frankle M, Mighell M, Pupello D. The use of the reverse shoulder prosthesis for the treatment of failed hemiarthroplasty for proximal humeral fracture. J Bone Joint Surg Am. 2007;89:292–300.PubMedCrossRef
20.
go back to reference Matsen FA 3rd, Boileau P, Walch G, Gerber C, Bicknell RT. The reverse total shoulder arthroplasty. J Bone Joint Surg Am. 2007;89:660–667.PubMed Matsen FA 3rd, Boileau P, Walch G, Gerber C, Bicknell RT. The reverse total shoulder arthroplasty. J Bone Joint Surg Am. 2007;89:660–667.PubMed
21.
go back to reference Nwakama AC, Cofield RH, Kavanagh BF, Loehr JF. Semiconstrained total shoulder arthroplasty for glenohumeral arthritis and massive rotator cuff tearing. J Shoulder Elbow Surg. 2000;9:302–307.PubMedCrossRef Nwakama AC, Cofield RH, Kavanagh BF, Loehr JF. Semiconstrained total shoulder arthroplasty for glenohumeral arthritis and massive rotator cuff tearing. J Shoulder Elbow Surg. 2000;9:302–307.PubMedCrossRef
22.
go back to reference Rittmeister M, Kerschbaumer F. Grammont reverse total shoulder arthroplasty in patients with rheumatoid arthritis and nonreconstructible rotator cuff lesions. J Shoulder Elbow Surg. 2001;10:17–22.PubMedCrossRef Rittmeister M, Kerschbaumer F. Grammont reverse total shoulder arthroplasty in patients with rheumatoid arthritis and nonreconstructible rotator cuff lesions. J Shoulder Elbow Surg. 2001;10:17–22.PubMedCrossRef
23.
go back to reference Rockwood CA Jr. The reverse total shoulder prosthesis: the new kid on the block. J Bone Joint Surg Am. 2007;89:233–235.PubMedCrossRef Rockwood CA Jr. The reverse total shoulder prosthesis: the new kid on the block. J Bone Joint Surg Am. 2007;89:233–235.PubMedCrossRef
24.
go back to reference Simovitch RW, Zumstein MA, Lohri E, Helmy N, Gerber C. Predictors of scapular notching in patients managed with the Delta III reverse total shoulder replacement. J Bone Joint Surg Am. 2007;89:588–600.PubMedCrossRef Simovitch RW, Zumstein MA, Lohri E, Helmy N, Gerber C. Predictors of scapular notching in patients managed with the Delta III reverse total shoulder replacement. J Bone Joint Surg Am. 2007;89:588–600.PubMedCrossRef
25.
go back to reference Sirveaux F, Favard L, Oudet D, Huguet D, Lautman S. Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive and nonrepairable cuff rupture. In: Walch G, Boileau P, Mole D, eds. Shoulder Prosthesis: Two to Ten Year Follow-up. Montpellier, France: Sauramps Medical; 2001:247–252. Sirveaux F, Favard L, Oudet D, Huguet D, Lautman S. Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive and nonrepairable cuff rupture. In: Walch G, Boileau P, Mole D, eds. Shoulder Prosthesis: Two to Ten Year Follow-up. Montpellier, France: Sauramps Medical; 2001:247–252.
26.
go back to reference Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Mole D. Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff: results of a multicentre study of 80 shoulders. J Bone Joint Surg Br. 2004;86:388–395.PubMedCrossRef Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Mole D. Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff: results of a multicentre study of 80 shoulders. J Bone Joint Surg Br. 2004;86:388–395.PubMedCrossRef
27.
go back to reference Taylor HD, Dennis DA, Crane HS. Relationship between mortality rates and hospital patient volume for Medicare patients undergoing major orthopaedic surgery of the hip, knee, spine, and femur. J Arthroplasty. 1997;12:235–242.PubMedCrossRef Taylor HD, Dennis DA, Crane HS. Relationship between mortality rates and hospital patient volume for Medicare patients undergoing major orthopaedic surgery of the hip, knee, spine, and femur. J Arthroplasty. 1997;12:235–242.PubMedCrossRef
28.
go back to reference Valenti PH, Boutens D, Nerot C. Delta 3 reversed prosthesis for osteoarthritis with massive rotator cuff tear: long-term results (> 5 years). In: Walch G, Boileau P, Mole D, eds. Shoulder Prosthesis: Two to Ten Year Follow-up. Montpellier, France: Sauramps Medical; 2001:253–259. Valenti PH, Boutens D, Nerot C. Delta 3 reversed prosthesis for osteoarthritis with massive rotator cuff tear: long-term results (> 5 years). In: Walch G, Boileau P, Mole D, eds. Shoulder Prosthesis: Two to Ten Year Follow-up. Montpellier, France: Sauramps Medical; 2001:253–259.
29.
go back to reference Vanhove B, Beugnies A. Grammont’s reverse shoulder prosthesis for rotator cuff arthropathy: a retrospective study of 32 cases. Acta Orthop Belg. 2004;70:219–225.PubMed Vanhove B, Beugnies A. Grammont’s reverse shoulder prosthesis for rotator cuff arthropathy: a retrospective study of 32 cases. Acta Orthop Belg. 2004;70:219–225.PubMed
30.
go back to reference Werner CM, Steinmann PA, Gilbart M, Gerber C. Treatment of painful pseudoparesis due to irreparable rotator cuff dysfunction with the Delta III reverse-ball-and-socket total shoulder prosthesis. J Bone Joint Surg Am. 2005;87:1476–1486.PubMedCrossRef Werner CM, Steinmann PA, Gilbart M, Gerber C. Treatment of painful pseudoparesis due to irreparable rotator cuff dysfunction with the Delta III reverse-ball-and-socket total shoulder prosthesis. J Bone Joint Surg Am. 2005;87:1476–1486.PubMedCrossRef
Metadata
Title
Reverse Total Shoulder Replacement: Intraoperative and Early Postoperative Complications
Authors
Carl Wierks, MD
Richard L. Skolasky, ScD
Jong Hun Ji, MD
Edward G. McFarland, MD
Publication date
01-01-2009
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 1/2009
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-008-0406-1

Other articles of this Issue 1/2009

Clinical Orthopaedics and Related Research® 1/2009 Go to the issue

Symposium: Papers Presented at the Hip Society Meetings 2008

Isolated Polyethylene Exchange versus Acetabular Revision for Polyethylene Wear