A COMPARISON OF A REVERSE BALL AND SOCKET PROSTHESIS (RSP) AS A SALVAGE PROCEDURE FOR FAILED SHOULDER RECONSTRUCTION TO A PRIMARY REVERSE PROSTHESIS FOR ROTATOR CUFF ARTHROPATHY OR PRIMARY ROTATOR CUFF DEFICIENCY WITH IDIOPATHIC SUPERIOR ARCH INSTABILITY

M.A. Frankle; M.A. Mighell; A. Kumar

doi:10.1302/0301-620X.86BSUPP_I.0860007c

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A COMPARISON OF A REVERSE BALL AND SOCKET PROSTHESIS (RSP) AS A SALVAGE PROCEDURE FOR FAILED SHOULDER RECONSTRUCTION TO A PRIMARY REVERSE PROSTHESIS FOR ROTATOR CUFF ARTHROPATHY OR PRIMARY ROTATOR CUFF DEFICIENCY WITH IDIOPATHIC SUPERIOR ARCH INSTABILITY

M.A. Frankle
M.A. Mighell
A. Kumar

A COMPARISON OF A REVERSE BALL AND SOCKET PROSTHESIS (RSP) AS A SALVAGE PROCEDURE FOR FAILED SHOULDER RECONSTRUCTION TO A PRIMARY REVERSE PROSTHESIS FOR ROTATOR CUFF ARTHROPATHY OR PRIMARY ROTATOR CUFF DEFICIENCY WITH IDIOPATHIC SUPERIOR ARCH INSTABILITY

Frankle M, Mighell M, Kumar A. A COMPARISON OF A REVERSE BALL AND SOCKET PROSTHESIS (RSP) AS A SALVAGE PROCEDURE FOR FAILED SHOULDER RECONSTRUCTION TO A PRIMARY REVERSE PROSTHESIS FOR ROTATOR CUFF ARTHROPATHY OR PRIMARY ROTATOR CUFF DEFICIENCY WITH IDIOPATHIC SUPERIOR ARCH INSTABILITY. Orthop Procs. 2004;86-B(SUPP_I):7-7. doi:10.1302/0301-620X.86BSUPP_I.0860007c

Frankle, M.A., et al. “A COMPARISON OF A REVERSE BALL AND SOCKET PROSTHESIS (RSP) AS A SALVAGE PROCEDURE FOR FAILED SHOULDER RECONSTRUCTION TO A PRIMARY REVERSE PROSTHESIS FOR ROTATOR CUFF ARTHROPATHY OR PRIMARY ROTATOR CUFF DEFICIENCY WITH IDIOPATHIC SUPERIOR ARCH INSTABILITY.” Orthopaedic Proceedings, vol. 86-B, no. SUPP_I, 2004, pp. 7-7., https://doi.org/10.1302/0301-620X.86BSUPP_I.0860007c

Frankle, M., Mighell, M., & Kumar, A. (2004). A COMPARISON OF A REVERSE BALL AND SOCKET PROSTHESIS (RSP) AS A SALVAGE PROCEDURE FOR FAILED SHOULDER RECONSTRUCTION TO A PRIMARY REVERSE PROSTHESIS FOR ROTATOR CUFF ARTHROPATHY OR PRIMARY ROTATOR CUFF DEFICIENCY WITH IDIOPATHIC SUPERIOR ARCH INSTABILITY. Orthopaedic Proceedings, 86-B(SUPP_I), 7-7. https://doi.org/10.1302/0301-620X.86BSUPP_I.0860007c

Frankle, M., Mighell, M. and Kumar, A. (2004) “A COMPARISON OF A REVERSE BALL AND SOCKET PROSTHESIS (RSP) AS A SALVAGE PROCEDURE FOR FAILED SHOULDER RECONSTRUCTION TO A PRIMARY REVERSE PROSTHESIS FOR ROTATOR CUFF ARTHROPATHY OR PRIMARY ROTATOR CUFF DEFICIENCY WITH IDIOPATHIC SUPERIOR ARCH INSTABILITY.” Orthopaedic Proceedings, 86-B(SUPP_I), pp. 7-7. Available at: https://doi.org/10.1302/0301-620X.86BSUPP_I.0860007c

Frankle, M.A., M.A. Mighell, and A. Kumar. “A COMPARISON OF A REVERSE BALL AND SOCKET PROSTHESIS (RSP) AS A SALVAGE PROCEDURE FOR FAILED SHOULDER RECONSTRUCTION TO A PRIMARY REVERSE PROSTHESIS FOR ROTATOR CUFF ARTHROPATHY OR PRIMARY ROTATOR CUFF DEFICIENCY WITH IDIOPATHIC SUPERIOR ARCH INSTABILITY.” Orthopaedic Proceedings 86-B, no. SUPP_I (2004): 7-7. https://doi.org/10.1302/0301-620X.86BSUPP_I.0860007c

Frankle M, Mighell M, Kumar A. A COMPARISON OF A REVERSE BALL AND SOCKET PROSTHESIS (RSP) AS A SALVAGE PROCEDURE FOR FAILED SHOULDER RECONSTRUCTION TO A PRIMARY REVERSE PROSTHESIS FOR ROTATOR CUFF ARTHROPATHY OR PRIMARY ROTATOR CUFF DEFICIENCY WITH IDIOPATHIC SUPERIOR ARCH INSTABILITY. Orthop Procs. 2004 Jan 1;86-B(SUPP_I):7-7. https://doi.org/10.1302/0301-620X.86BSUPP_I.0860007c

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Abstract

Outcomes for a RSP to treat either a previous operated shoulder (revision procedure) was compared to a primary RSP.

Twenty primary RSP (6M, 14F) for an irreparable rotator cuff tear (IRCT) with glenohumeral arthritis /anterior superior arch deficiency and 31 revision RSP (10M, 21F) (previous rotator or cuff surgery, hemi or total shoulder arthroplasty) were evaluated at an average of 24 months postoperatively. Mean age at the time of RSP was 72.3 for primaries 67.2 for revisions. Assessment with pre- and postoperatively SF-36, SST, ASES scores, physical exam, satisfaction surveys, and radiographs was performed.

Primary RSP improvements /Revision RSP improvements were: 9.4 sf-36 PCS/ 6.3 sf-36 PCS, 1.8 SST/ 1.6 SST,31.8ASES / 17.5ASES (p< 0.05),49.2 elevation/ 14.2 elevation (p< 0.05) and 57.8 external rotation/ 30 external rotation. 71.3% Excellent/good/. 56% Excellent/ good (p< 0.05), 21.4% satisfactory/ 33.3% satisfactory, 7.1% unsatisfactory outcome/ 9.5% unsatisfactory outcome. Complications only occurred in the revisions including component disassociation, glenoid loosening, recurrent instability, and infection

Primary RSP provides predictable improvements in pain and function with minimal complications. Revision RSP has a higher complication rate and improvements in pain and function are less reliable. Conventional shoulder arthroplasty for patients with IRCT with gle-nohumeral arthritis/anterior superior arch deficiency has resulted in adequate pain relief but functional improvement has not been predictable. Thus, the initial operative selection for these patients must consider the effect of a failed reconstructive attempt on patient outcomes.

The abstracts were prepared by Nico Verdoschot. Correspondence should be addressed to him at Orthopaedic Research Laboratory, Universitair Medisch Centrum, Orthopaedie / CSS1, Huispost 800, Postbus 9101, 6500 HB Nijmegen, Th. Craanenlaan 7, 6525 GH Nijmegen, The Netherlands.