Systematic review
Problems, complications, reoperations, and revisions in reverse total shoulder arthroplasty: A systematic review

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Definitions

We defined a problem as an intraoperative or postoperative event that was not likely to affect the patient’s final outcome, including radiographic scapular notching, hematomas, heterotopic ossification, algodystrophy, phlebitis, intraoperative dislocations, intraoperative cement extravasation, or radiographic lucent lines of the glenoid.

A complication was defined as any intraoperative or postoperative event that was likely to have a negative influence on the patient’s final outcome, including

Literature search

We identified 84 articles in English, French, German, and Spanish involving human subjects. The abstracts of these 84 studies were reviewed to determine the applicability to the present study as determined by the inclusion and exclusion criteria, including a worksheet adapted from evidence-based guides.84, 101 We rejected 63 articles because of follow-up of less than 24 months,14, 28, 36 absence of complication data in the study,56, 80, 81 publication in another language than the reported 4,71,

Discussion

Treatment of the rotator cuff deficient shoulder has evolved during the last 2 decades, and today RSA is a commonly performed procedure in Europe and all over the world. There has been growing interest in using RSA and indications continue to expand. However, high rates of problems, complications, reoperations, and revisions have been reported with the procedure.

On the basis of the present study, the global rates for problems, complications, reoperations, and revisions after RSA were 44%, 24%,

Conclusions

Problems, complications, reoperations, and revisions after RSA are frequent (44%, 24%, 3.5%, and 10% respectively). Scapular notching is a common problem but is rarely clinically significant. Although reoperations were equal in the REV and primary arthroplasty group, REV arthroplasty as an etiology has an effect, with a higher average problem, complication, and revision rate of 12.5%, 33.3%, and 15.7%, respectively. Instability and infection were the 2 most frequent complications leading to

Disclaimer

This is a systematic review of the literature concerning problems and complications encountered with all types of RSA (Depuy, Tornier, Encore). Any royalties and/or consultant payments received are not related directly to the subject matter or content of this article. The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.

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