Sometimes reverse total shoulder arthroplasty surgery needs surgical follow up. It's not that the original surgery was poorly done, it's just the procedure is complicated and the outcome is not guaranteed.
Four hundred forty one patients who were operated between 1999 and 2008 were followed. Of them, sixty seven had follow up surgical procedures. Reasons for additional surgery were identified and the first 37 patients were followed for two years.
Some patients needed only one additional surgery but 30 of them required a second procedure, 11 needed a third procedure and four had a fourth.
The most common reason for additional treatment was instability of the new joint, 18%. Hematoma or Wound problems accounted for 15% of follow up surgery. And 12% experienced glenoid problems that required surgery. In spite of this unexpected complication, objective scoring of procedure results revealed that patients benefitted from the treatment in general and had improved comfort and use of the operated arm.
Other complications were scapular notching, infection and acromioal fractures. These were not treated surgically.
Two things to note: this study followed surgeries performed in the early years of this operation coming to the U.S. Experience has likely reduced the rate of complications. And, in spite of requiring follow up surgical procedures (never what you want to hear recommended), follow up revealed improved and satisfied patients.
Replacing body parts with prosthetic devices is big surgery and changing the configuration of the original joint and bone shaft is a major revision of nature. It's no surprise that there can be problems. It appears, statistically, that the end justifies the means and, in spite of requiring additional surgery, patients benefitted from the operation and had improved shoulder function and comfort.
Hooray!
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