Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Sep 7;4(4):929-943.
doi: 10.1016/j.jseint.2020.07.017. eCollection 2020 Dec.

The modern reverse shoulder arthroplasty and an updated systematic review for each complication: part I

Sarav S Shah  1 , Benjamin T Gaal  1 , Alexander M Roche  1 , Surena Namdari  1 , Brian M Grawe  1 , Macy Lawler  1 , Stewart Dalton  1 , Joseph J King  1 , Joshua Helmkamp  1 , Grant E Garrigues  1 , Thomas W Wright  1 , Bradley S Schoch  1 , Kyle Flik  1 , Randall J Otto  1 , Richard Jones  1 , Andrew Jawa  1 , Peter McCann  1 , Joseph Abboud  1 , Gabe Horneff  1 , Glen Ross  1 , Richard Friedman  1 , Eric T Ricchetti  1 , Douglas Boardman  1 , Robert Z Tashjian  1 , Lawrence V Gulotta  1
Affiliations
Review

The modern reverse shoulder arthroplasty and an updated systematic review for each complication: part I

Sarav S Shah et al. JSES Int. .

Abstract

Background: Globally, reverse shoulder arthroplasty (RSA) has moved away from the Grammont design to modern prosthesis designs. The purpose of this 2-part study was to systematically review each of the most common complications of RSA, limiting each search to publications in 2010 or later. In this part (part I), we examined (1) scapular notching (SN), (2) periprosthetic infection (PJI), (3) mechanical failure (glenoid or humeral component), and (4) neurologic injury (NI).

Methods: Four separate PubMed database searches were performed following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Overall, 113 studies on SN, 62 on PJI, 34 on mechanical failure, and 48 on NI were included in our reviews. Univariate analysis was performed with the χ2 or Fisher exact test.

Results: The Grammont design had a higher SN rate vs. all other designs combined (42.5% vs. 12.3%, P < .001). The onlay humeral design had a lower rate than the lateralized glenoid design (10.5% vs. 14.8%, P < .001). The PJI rate was 2.4% for primary RSA and 2.6% for revision RSA. The incidence of glenoid and humeral component loosening was 2.3% and 1.4%, respectively. The Grammont design had an increased NI rate vs. all other designs combined (0.9% vs. 0.1%, P = .04).

Conclusions: Focused systematic reviews of the recent literature with a large volume of RSAs demonstrate that with the use of non-Grammont modern prosthesis designs, complications including SN, PJI, glenoid component loosening, and NI are significantly reduced compared with previous studies. As the indications for RSA continue to expand, it is imperative to accurately track the rates and types of complications to justify its cost and increased indications.

Keywords: Reverse shoulder arthroplasty; complications; infection; loosening; neurologic injury; scapular notching.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-analyses diagram for scapular notching.
Figure 2
Figure 2
Preferred Reporting Items for Systematic Reviews and Meta-analyses diagram for periprosthetic infection.
Figure 3
Figure 3
Preferred Reporting Items for Systematic Reviews and Meta-analyses diagram for mechanical failure.
Figure 4
Figure 4
Preferred Reporting Items for Systematic Reviews and Meta-analyses diagram for neurologic injury.
See this image and copyright information in PMC

References

    1. Abdel M.P., Hattrup S.J., Sperling J.W., Cofield R.H., Kreofsky C.R., Sanchez-Sotelo J. Revision of an unstable hemiarthroplasty or anatomical total shoulder replacement using a reverse design prosthesis. Bone Joint J. 2013;95-B:668–672. doi: 10.1302/0301-620X.95B5.30964. - DOI - PubMed
    1. Aibinder W.R., Clark N.J., Schoch B.S., Steinmann S.P. Assessing glenosphere position: superior approach versus deltopectoral for reverse shoulder arthroplasty. J Shoulder Elbow Surg. 2018;27:455–462. doi: 10.1016/j.jse.2017.10.013. - DOI - PubMed
    1. Aibinder W.R., Schoch B.S., Cofield R.H., Sperling J.W., Sánchez-Sotelo J. Reverse shoulder arthroplasty in patients with os acromiale. J Shoulder Elbow Surg. 2017;26:1598–1602. doi: 10.1016/j.jse.2017.02.012. - DOI - PubMed
    1. Al-Hadithy N., Domos P., Sewell M.D., Pandit R. Reverse shoulder arthroplasty in 41 patients with cuff tear arthropathy with a mean follow-up period of 5 years. J Shoulder Elbow Surg. 2014;23:1662–1668. doi: 10.1016/j.jse.2014.03.001. - DOI - PubMed
    1. Aleem A.W., Feeley B.T., Austin L.S., Ma C.B., Krupp R.J., Ramsey M.L. Effect of humeral component version on outcomes in reverse shoulder arthroplasty. Orthopedics. 2017;40:179–186. doi: 10.3928/01477447-20170117-04. - DOI - PubMed