Abstract
BACKGROUND: Despite the increasing use of revision reverse total shoulder arthroplasty (RTSA), studies directly comparing revision RTSA performed for different failed index procedures are limited. We therefore compared the results of revision RTSA between patients with a failed primary anatomic arthroplasty (total shoulder arthroplasty and hemiarthroplasty) and those with a failed primary RTSA to explore revision of which index procedure resulted in better long-term clinical outcomes. METHODS: In this prospective, multicenter, observational study, patients underwent revision RTSA using an inverted-bearing prosthesis. We recorded clinical scores, active range of motion, pain, satisfaction, and the rate of scapular notching. Complications and prosthesis survival were also noted. RESULTS: We included 45 patients (45 shoulders) with revision RTSA for failed primary anatomic shoulder arthroplasty (30 patients) and RTSA (15 patients). Clinical and radiographic outcomes were recorded from 36 patients at a median follow-up of 101.6 months, and prosthesis survival was assessed from all 45 patients. At final follow-up, clinical scores (P < .05), abduction (P = .032), re-revision rate (P = .018), and prosthesis survival (P = .015) were significantly better in patients revised from failed primary anatomic shoulder arthroplasty than those from RTSA. However, pain, satisfaction, and overall complication rates were similar in both groups (P > .05). CONCLUSIONS: We found better long-term clinical scores, abduction, and prosthesis survival rates after failed primary anatomic shoulder arthroplasty than after RTSA. Pain reduction and complication rates were comparable in both groups. Thus, anatomic shoulder arthroplasty remains an attractive option for primary arthroplasty in selected cases.