Failure Of Anatomic Total Shoulder Arthroplasty With Revision To Another Anatomic Total Shoulder Arthroplasty

Background: While outcomes of primary anatomic total shoulder arthroplasty (aTSA) are generally favorable, results after revision procedures are less reliable. This study examines the functional outcomes, complications, and implant survival in patients who underwent revision of aTSA to aTSA.Methods: Patients who underwent revision aTSA were identified from 2008-2015. Demographic, clinical, surgical, and outcomes data were analyzed. Patient-reported outcomes including the American Shoulder and Elbow Surgeons Score (ASES), Single Assessment Numerical Evaluation (SANE), Visual Analog Scale for pain (VAS), the Short Form12 Health Survey (SF-12), and patient satisfaction were recorded.Results: Twenty patients underwent revision from a primary aTSA to aTSA (55% male, 62.0 +/- 6.8 years-old). Revision aTSA occurred at 2.5 +/- 3.4 years after index surgery. Seven (35%) required future revision at 1.8 +/- 1.9 years after revision aTSA. Among the 13 patients who did not undergo revision, twelve (92.3%) had over two-year follow-up (4.0 +/- 2.4 years). Average ASES score was 70.1 +/- 23.5, SANE 66.0 +/- 29.4, VAS 2.7 +/- 3.0, SF-12 Mental 52.4 +/- 10.5, SF-12 Physical 36.8 +/- 8.9, and satisfaction of 3.6 +/- 1.2.Conclusion: Results of revision aTSA to aTSA were unpredictable and the revision rate was high. The cases that do not undergo revision had satisfactory, but inconsistent functional results. Reverse arthroplasty may be more reliable in this patient population.Level of evidence: IV