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 preand 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 megahead 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.