Clinical outcomes in patients undergoing reverse shoulder arthroplasty for dislocation arthropathy : a matched case-control study.

Abstract

Aims: Dislocation arthropathy of the shoulder is an advanced arthritis resulting from recurrent glenohumeral dislocation with or without previous stabilization surgery. The aim of this study was to compare the clinical results of reverse total shoulder arthroplasty (RTSA) in patients with dislocation arthropathy with those with primary osteoarthritis (OA) and glenoid bone loss.

Methods: This was a retrospective matched cohort study including 22 patients with dislocation arthropathy who were treated by one surgeon between 2011 and 2021 and a matched group of 44 patients who were also treated with RTSA, for OA. All patients had a minimum follow-up of two years and were treated with one of two RTSA systems, both with a lateralized glenoid sphere, a 135° neck-shaft angle and an uncemented humeral component, but differing by inlay versus onlay humeral tray. The glenoids were reamed eccentrically until there was at least 90% cover of the baseplate. No bone grafting or augmented glenoid components were used. Range of motion (ROM) and patient-reported outcome measures (PROMs) were recorded preoperatively and at final follow-up.

Results: Implant survival at final follow-up was 100% in the dislocation arthropathy group and 98% in the OA group. Both groups showed significant improvements in all PROMs and all ROMs, and there was no significant difference in these improvements between the groups. The complication rate was similar in the two groups (9% in the dislocation arthropathy group and 11% in the OA group).

Conclusion: The clinical results of RTSA performed in patients with dislocation arthropathy were comparable to those in a matched group of patients with OA. Although these findings suggest that RTSA is a successful surgical treatment for patients with dislocation arthropathy, longer follow-up is needed.