Favard, Clin Orthop Relat Res 2011 - Reverse Prostheses in Arthropathies with Cuff Tear: Are Survivorship and Function Maintained over Time?

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Reverse Prostheses in Arthropathies with Cuff Tear: Are Survivorship and Function Maintained over Time?

Favard, Mole, et al.·Clin Orthop Relat Res·2011·414 citations

Free Full Text·DOI·PubMed

Background

The use of reverse shoulder arthroplasty has considerably increased since first introduced in 1985. Despite demonstrating early improvement of function and pain, there is limited information regarding the durability and longer-term outcomes of this prosthesis.

Purpose

We determined complication rates, functional scores over time, survivorship, and whether radiographs would develop signs of loosening.

Methods

We retrospectively reviewed 527 reverse shoulder arthroplasties performed in 506 patients between 1985 and 2003.
Clinical and radiographic assessment was performed in 464 patients with a minimum followup of 2 years and 148 patients with a minimum followup of 5 years (mean, 7.5 years; range, 5-17 years).
Cumulative survival curves were established with end points being prosthesis revision and Constant-Murley score of less than 30 points.

Results

89 of 489 had at least one complication for a total of 107 complications.
Survivorship free of revision was 89% at 10 years with a marked break occurring at 2 and 9 years.
Survivorship to a Constant-Murley score of less than 30 was 72% at 10 years with a marked break observed at 8 years.
We observed progressive radiographic changes after 5 years and an increasing frequency of large notches with long-term followup.

Conclusions

Although the need for revision of reverse shoulder arthroplasty was relatively low at 10 years, Constant-Murley score and radiographic changes deteriorated with time. These findings are concerning regarding the longevity of the reverse shoulder arthroplasty, and therefore caution must be exercised when recommending reverse shoulder arthroplasty, especially in younger patients.

Level of evidence: Level IV, therapeutic study. Copyright remains with the authors and publisher.

Reverse Prostheses in Arthropathies with Cuff Tear: Are Survivorship and Function Maintained over Time?

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Reverse Prostheses in Arthropathies with Cuff Tear: Are Survivorship and Function Maintained over Time?

Favard, Mole, et al.·Clin Orthop Relat Res·2011·414 citations

Free Full Text·DOI·PubMed

Background

The use of reverse shoulder arthroplasty has considerably increased since first introduced in 1985. Despite demonstrating early improvement of function and pain, there is limited information regarding the durability and longer-term outcomes of this prosthesis.

Purpose

We determined complication rates, functional scores over time, survivorship, and whether radiographs would develop signs of loosening.

Methods

We retrospectively reviewed 527 reverse shoulder arthroplasties performed in 506 patients between 1985 and 2003.
Clinical and radiographic assessment was performed in 464 patients with a minimum followup of 2 years and 148 patients with a minimum followup of 5 years (mean, 7.5 years; range, 5-17 years).
Cumulative survival curves were established with end points being prosthesis revision and Constant-Murley score of less than 30 points.

Results

89 of 489 had at least one complication for a total of 107 complications.
Survivorship free of revision was 89% at 10 years with a marked break occurring at 2 and 9 years.
Survivorship to a Constant-Murley score of less than 30 was 72% at 10 years with a marked break observed at 8 years.
We observed progressive radiographic changes after 5 years and an increasing frequency of large notches with long-term followup.

Conclusions

Although the need for revision of reverse shoulder arthroplasty was relatively low at 10 years, Constant-Murley score and radiographic changes deteriorated with time. These findings are concerning regarding the longevity of the reverse shoulder arthroplasty, and therefore caution must be exercised when recommending reverse shoulder arthroplasty, especially in younger patients.

Level of evidence: Level IV, therapeutic study. Copyright remains with the authors and publisher.

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