Defining the tipping point for revision reverse shoulder arthroplasty

Author:

Buchanan Timothy R1ORCID,Hao Kevin A2ORCID,Cueto Robert J1ORCID,Bindi Victoria E1,O’Keefe Daniel S1ORCID,Hones Keegan M2,Krisanda Emily K2,Wright Jonathan O2ORCID,Wright Thomas W2,Farmer Kevin W2,Struk Aimee M2,Schoch Bradley S3ORCID,King Joseph J2ORCID

Affiliation:

1. College of Medicine, University of Florida, Gainesville, FL, USA

2. Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USA

3. Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL, USA

Abstract

Background This study sought to characterize the tipping point values (the functional scores that patients deem dysfunctional enough to warrant surgery) for patients undergoing first revision reverse total shoulder arthroplasty (rTSA). Methods This study was a retrospective review of a prospectively collected single-institution database of patients undergoing first revision rTSA between August 2015 and December 2019. Tipping point evaluation utilized preoperative scores including the American Shoulder and Elbow Surgeons (ASES), raw and normalized Constant, Shoulder Pain and Disability Index (SPADI), Simple Shoulder Test (SST), and University of California-Los Angeles (UCLA) scores, and active range of motion including abduction, forward elevation (FE), external rotation (ER), and internal rotation score (IR) prior to elective revision rTSA. Results We included 125 revision rTSAs. Tipping points were 37.6 ASES score, 30.5 raw Constant score, 35.5 normalized Constant score, 68.1 SPADI, 3.7 SST, 13.2 UCLA score, 64° abduction, 69° FE, 23° ER, and 3.1 IR. Higher SST was found for older patients and patients with a lower body mass index. Lower abduction and FE tipping points were reported in patients undergoing revision rTSA for rotator cuff failure, unexplained pain, and implant wear. Discussion These tipping points can help surgeons counsel patients regarding when to undergo revision rTSA. Level of evidence Level III; retrospective cohort study; treatment study.

Publisher

SAGE Publications

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