Clinical Science Research
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Background: The primary purpose of this study was to determine the average time from hemiarthoplasty (HA) or total shoulder arthroplasty (TSA) to conversion to reverse total shoulder arthroplasty (RTSA). The secondary purpose of this study was to determine the factors leading to conversion to RTSA.
Methods: A review of the literature regarding the existing evidence for conversion of HA/TSA to RTSA was performed using the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed (1980-present), and MEDLINE (1980-present). nclusion criteria were as follows: reporting of conversion of a HA or TSA to RTSA with a follow up of greater than 24 months, English language, and human studies. Excluded were articles that did not mention a time to conversion surgery.
Results: One hundred studies were initially retrieved with 3 meeting the inclusion criteria. The review included 99 patients (31 male, 68 female) with a mean age 69 (range: 67 – 73). The average follow up was 35.8 months (range: 32.3 – 37.4). The weighted mean time to conversion of HA/TSA to RTSA was 36.8 months. Rotator cuff failure was the indication for conversion in 19 66% of cases (65/99), while component loosening (glenoid or humeral stem) was the indication in 14% (14/99) of cases.
Conclusions: Time to conversion of HA/TSA to RTSA is reported to be 36.8 months on average. The most common indication for conversion to RTSA was rotator cuff failure, suggesting the importance of evaluating pre-operative rotator cuff integrity when performing a primary HA or TSA.
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