Authors’ Disclosure Statement: All authors report that they receive royalties for a shoulder prosthesis design from FH Orthopedics.
Dr. Valenti is an Orthopedic Surgeon, and Dr. Werthel is an Assistant, Paris Shoulder Unit, Clinique Bizet, Paris, France. Dr. Katz is an Orthopedic Surgeon, Douar Gwen, Ploemeur, France. Dr. Kany is an Orthopedic Surgeon, Clinique de l’Union, Saint-Jean, France.
Address correspondence to: Philippe Valenti, MD, Paris Shoulder Unit, Clinique Bizet, 21 rue Georges Bizet, 75116 Paris, France (email, Philippe.valenti@wanadoo.fr).
Philippe Valenti, MD Denis Katz, MD Jean Kany, MD Jean-David Werthel, MD, MS . Convertible Glenoid Components Facilitate Revisions to Reverse Shoulder Arthroplasty Easier: Retrospective Review of 13 Cases . Am J Orthop. February 8, 2018
TAKE-HOME POINTS
Full polyethylene is the gold standard, but the revision of glenoid loosening leads a difficult reconstruction of a glenoid bone.
A complete convertible system facilitates the revision and decreases the rate of complications.
The functional and subjective results of the revision are good.
During the revision, the metalback was well fixed without any sign of loosening.
In 3 cases the humeral stem was changed; in 2 cases there was no space to reduce (onlay system) and in 1 case it was an older design, nonadapted.
References
ABSTRACT
Removal of a cemented glenoid component often leads to massive glenoid bone loss, which makes it difficult to implant a new glenoid baseplate. The purpose of this study was to demonstrate the feasibility of revisions with a completely convertible system and to report clinical and radiographic results of a retrospective review of 13 cases.
Between 2003 and 2011, 104 primary total shoulder arthroplasties (TSAs) were performed with an uncemented glenoid component in our group. Of these patients, 13 (average age, 64 years) were revised to reverse shoulder arthroplasty (RSA) using a modular convertible platform system and were included in this study. Average follow-up after revision was 22 months. Outcome measures included pain, range of motion, Constant-Murley scores, Simple Shoulder Tests, and subjective shoulder values. Active flexion increased significantly from a mean of 93° (range, 30°-120°) to 138° (range, 95°-170°) (P = 0.021), and active external rotation increased significantly from 8° (range, −20°-15°) to 25° (range, −10°-60°). Mean pain scores significantly improved from 4.2 to 13.3 points. The mean Constant Scores improved from 21 (range, 18-32) to 63 (range, 43-90). Subjectively, 12 patients rated their shoulder as better or much better than preoperatively. This retrospective study shows that a complete convertible system facilitates conversion of TSAs to RSAs with excellent pain relief and a significant improvement in shoulder function.
