Portal de Periódicos da CAPES

9

2007; Elsevier BV; Volume: 16; Issue: 2 Linguagem: Inglês

10.1016/j.jse.2007.02.058

1532-6500

Bryan Wall, F. Mottier, Gilles Walch,

Introduction: Rates of complications and revision in reverse shoulder arthroplasty (RSA) have yet to be well defined. The purpose of this study was to describe complications and revisions occurring in a large, multicenter series. Materials and Methods: From January 1992 to December 2002, 457 RSAs were placed in five surgical centers. 297 reverse arthroplasties were performed in patients with no prior surgery. 94 prostheses were done for revision of a failed hemi- or total shoulder arthroplasty. 70 prostheses were implanted after a failed shoulder procedure other than arthroplasty. Patients were evaluated using pre- and postoperative range of motion, Constant scores and standardized radiographs. Results: 25.6% of all cases experienced at least one intra- or postoperative complication. There were 39 intraoperative complications, including 28 humerus fractures and 11 glenoid fractures. The rate of intraoperative complication was higher in revision arthroplasty (30.9%) than in primary arthroplasty (2.7%) (p<0.001). There were 80 postoperative complications. Postoperative complication was more frequent in the revision group (33.6%) than the primary group (12.6%) (p<0.001). Instability was most common followed by infection, humeral fracture, glenoid loosening, humeral loosening, humeral disassembly, glenoid disassembly, hematoma, neurapraxia, scapular spine fracture, postoperative stiffness, and venous thrombosis. Rates of dislocation, infection and humeral complications were significantly higher in the revision arthroplasty group (p<0.05). The deltopectoral approach had a higher rate of instability (5.8%) than the superolateral approach (1.0%) (p=0.05). Conclusions: Most intraoperative complications were related to revision of well-fixed humeral components. Revision RSA has a postoperative complication rate three times that of primary RSA. Dislocation was associated with the deltopectoral approach and revision surgery. If noted, the author indicates something of value received. The codes are identified as follows: a, research or institutional support; b, miscellaneous funding; c, royalties; d, stock options; e, consultant or employee. *The Food and Drug Administration has not cleared the drug and/or medical device for the use described in this presentation (ie, the drug or medical device is being discussed for an "off-label" use). If noted, the author indicates something of value received. The codes are identified as follows: a, research or institutional support; b, miscellaneous funding; c, royalties; d, stock options; e, consultant or employee. *The Food and Drug Administration has not cleared the drug and/or medical device for the use described in this presentation (ie, the drug or medical device is being discussed for an "off-label" use). If noted, the author indicates something of value received. The codes are identified as follows: a, research or institutional support; b, miscellaneous funding; c, royalties; d, stock options; e, consultant or employee. *The Food and Drug Administration has not cleared the drug and/or medical device for the use described in this presentation (ie, the drug or medical device is being discussed for an "off-label" use).