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. 2021 Feb;13(1):51-57.
doi: 10.1177/1758573219864266. Epub 2019 Jul 27.

Risk factors for instability after reverse shoulder arthroplasty

Vincenzo Guarrella  1 , Mikael Chelli  2 , Peter Domos  3 , Francesco Ascione  4   5 , Pascal Boileau  2 , Gilles Walch  6
Affiliations

Risk factors for instability after reverse shoulder arthroplasty

Vincenzo Guarrella et al. Shoulder Elbow. 2021 Feb.

Abstract

Background: This study aims to identify risk factors related to postoperative instability after reverse shoulder arthroplasty and evaluate the modalities and results of treatments in a large series of patients, with medium to long-term follow-up.

Methods: Retrospective multicenter series of 1035 consecutive Grammont type reverse shoulder arthroplasties implanted between 1992 and 2010. 19.9% had a reverse shoulder arthroplasty with bony lateralization on the glenoid side. Patients were reviewed and radiographed with minimum five years' follow-up.

Results: At a mean follow-up of eight years, the overall rate of postoperative instability was 3.0%. Instability was more frequent in case of reverse shoulder arthroplasty for revision surgery, in younger patients, in case of scapular notching, and tuberosity resorption. Lateralized reverse shoulder arthroplasties were associated with a lower instability rate. A reoperation to restore stability was needed in 70% of cases. The improvement in Constant Score was lower in patients with unstable reverse shoulder arthroplasties when compared to stable reverse shoulder arthroplasties.

Conclusions: Younger patients are at higher risk for instability after Grammont type reverse shoulder arthroplasty implantation. Conversely, lateralized reverse shoulder arthroplasties resulted protective. When conservative treatment had failed, shoulder stability can be obtained with reoperation or prosthetic revision (needed in 70% of the cases), but to the price of lower functional results.

Keywords: BIO-RSA; deltoid tensioning; dislocation; humeral lengthening; prosthetic instability; reverse shoulder arthroplasty complication.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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