Background and purposeReversed shoulder arthroplasty may be used for severe arthropathy where conventional prostheses cannot restore the function sufficiently. We analyzed the medium–term results and potential complications of the reversed prostheses, and also the influence of etiology on the result.Methods52 women and 7 men, average age 70 (60–82) years, were followed for mean 4 (2–7) years. The indications were cuff tear arthropathy (CTA) (23), fracture sequelae (20), and revision of a failed conventional arthroplasty (16).ResultsThe average Constant score improved from 18 (2–55) points to 59 (17–96) points. It rose from 26 to 74 points in patients with CTA, from 12 to 48 in those with fracture sequelae, and from 10 to 54 points in revision arthroplasty. We also found an overall improvement in active forward flexion from 47° to 105°, and in active abduction from 46° to 93°. Scapular notching was seen in 51 shoulders. Radiolucent lines below the base–plate were present in 2 cases. There were no instances of loosening. Revisions were necessary in 15 patients: 5 with infections (all had had prior surgery), 5 with hematoma, 3 with dislocations, and 2 with disconnections of the shaft components.InterpretationReversed prosthetic replacement is a suitable method for restoring function and attaining pain relief in severe arthropathies. The results in revision arthroplasty are less predictable, with complications and revision rates higher than those in CTA patients. The reversed prosthesis should therefore only be used when conventional methods have failed.
GOA affects the entire musculoskeletal system. The varying manifestation in individual joints and spinal segments is probably attributable to multifactorial local and systemic factors. In an earlier study, a genetic disposition with a maximum HA prevalence of 30% was identified in the study population. Since HA is considered a genetic marker for GOA, it can be assumed that the same is true of GOA prevalence.
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