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DOI: 10.1055/s-0041-1730974
Functional Outcomes of Bilateral Reverse Total Shoulder Arthroplasty: A Systematic Review
Funding None.![](https://www.thieme-connect.de/media/10.1055-s-00033766/201904/lookinside/thumbnails/10-1055-s-0041-1730974_1800058-1.jpg)
Abstract
Purpose To answer the question whether bilateral reverse total shoulder arthroplasty (RTSA) is a safe and effective treatment which results in satisfactory clinical and functional outcomes with low complications rates. A second question to be answered was: what is the quality of the evidence of the already published studies which investigate the use of bilateral RTSA?
Methods Two reviewers independently conducted a systematic search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews. These databases were queried with the terms “reverse” AND “total” AND “shoulder” AND “arthroplasty” AND “clinical.” Descriptive statistics were used to summarize the data.
Results From the 394 initial studies we finally selected and assessed 6 clinical studies which were eligible to our inclusion–exclusion criteria. The aforementioned studies included in total 203 patients (69% females; mean age range: 67.1–75 years; mean follow-up range: 12–61 months). From those, 168 patients underwent staged bilateral RTSA (mean duration between first and second operation range: 8–21.6 months) and the rest of them a unilateral RTSA as controlled treatment. Almost all mean clinical and functional scores, which were used to assess the therapeutic value of bilateral RTSA, depicted significant postoperative improvement in comparison with the mean preoperative values. The modified Coleman methodology score, which was used to assess the quality of the studies, ranged from a minimum of 36/100 to a maximum of 55/100.
Conclusion Despite the lack of high-quality evidence, staged bilateral RTSA seems to be a safe and effective procedure for patients with cuff tear arthropathy, which results in significantly improved clinical and functional outcomes and low reoperations' rates.
Level of Evidence Systematic review of level III-IV therapeutic studies.
Keywords
reverse total shoulder arthroplasty - staged bilateral arthroplasty - cuff tear arthropathy - systematic review - modified Coleman scorePublication History
Received: 17 July 2018
Accepted: 18 April 2021
Article published online:
18 June 2021
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Georg Thieme Verlag KG
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References
- 1 Chalmers PN, Keener JD. Expanding roles for reverse shoulder arthroplasty. Curr Rev Musculoskelet Med 2016; 9 (01) 40-48
- 2 Wright JO, Ho A, Kalma J. et al. Uncemented reverse total shoulder arthroplasty as initial treatment for comminuted proximal humerus fractures. J Orthop Trauma 2019; 33 (07) e263-e269
- 3 Luciani P, Farinelli L, Procaccini R, Verducci C, Gigante A. Primary reverse shoulder arthroplasty for acute proximal humerus fractures: a 5-year long term retrospective study of elderly patients. Injury 2019; 50 (11) 1974-1977
- 4 Gerber C, Canonica S, Catanzaro S, Ernstbrunner L. Longitudinal observational study of reverse total shoulder arthroplasty for irreparable rotator cuff dysfunction: results after 15 years. J Shoulder Elbow Surg 2018; 27 (05) 831-838
- 5 Grosel TW, Plummer DR, Everhart JS. et al. Reverse total shoulder arthroplasty provides stability and better function than hemiarthroplasty following resection of proximal humerus tumors. J Shoulder Elbow Surg 2019; 28 (11) 2147-2152
- 6 Holschen M, Franetzki B, Witt KA, Liem D, Steinbeck J. Conversions from anatomic shoulder replacements to reverse total shoulder arthroplasty: do the indications for initial surgery influence the clinical outcome after revision surgery?. Arch Orthop Trauma Surg 2017; 137 (02) 167-172
- 7 Bois AJ, Knight P, Alhojailan K, Bohsali KI. Clinical outcomes and complications of reverse shoulder arthroplasty used for failed prior shoulder surgery: a systematic review and meta-analysis. JSES Int 2020; 4 (01) 156-168
- 8 Levy O, Walecka J, Arealis G. et al. Bilateral reverse total shoulder arthroplasty-functional outcome and activities of daily living. J Shoulder Elbow Surg 2017; 26 (04) e85-e96
- 9 Sirveaux F, Mole D. Failures of the reverse prosthesis: identifying the problems. In: Cofield RH. ed. Revision and Complex Shoulder Arthroplasty. Philadelphia, PA: Lippincott Williams & Wilkins; 2010: 18-28
- 10 Wiater BP, Boone CR, Koueiter DM, Wiater JM. Early outcomes of staged bilateral reverse total shoulder arthroplasty: a case-control study. Bone Joint J 2013; 95-B (09) 1232-1238
- 11 Gerber C, Lingenfelter EJ, Reischl N, Sukthankar A. Single-stage bilateral total shoulder arthroplasty: a preliminary study. J Bone Joint Surg Br 2006; 88 (06) 751-755
- 12 Liberati A, Altman DG, Tetzlaff J. et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009; 339: b2700
- 13 Sambandam SN, Gul A, Priyanka P. Analysis of methodological deficiencies of studies reporting surgical outcome following cemented total-joint arthroplasty of trapezio-metacarpal joint of the thumb. Int Orthop 2007; 31 (05) 639-645
- 14 Mellano CR, Kupfer N, Thorsness R. et al. Functional results of bilateral reverse total shoulder arthroplasty. J Shoulder Elbow Surg 2017; 26 (06) 990-996
- 15 Wirth B, Kolling C, Schwyzer HK, Flury M, Audigé L. Risk of insufficient internal rotation after bilateral reverse shoulder arthroplasty: clinical and patient-reported outcome in 57 patients. J Shoulder Elbow Surg 2016; 25 (07) 1146-1154
- 16 Morris BJ, Haigler RE, O'Connor DP, Elkousy HA, Gartsman GM, Edwards TB. Outcomes of staged bilateral reverse shoulder arthroplasties for rotator cuff tear arthropathy. J Shoulder Elbow Surg 2015; 24 (03) 474-481
- 17 Stevens CG, Struk AM, Wright TW. The functional impact of bilateral reverse total shoulder arthroplasty. J Shoulder Elbow Surg 2014; 23 (09) 1341-1348
- 18 Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Molé D. Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Joint Surg Br 2004; 86 (03) 388-395
- 19 Clark JC, Ritchie J, Song FS. et al. Complication rates, dislocation, pain, and postoperative range of motion after reverse shoulder arthroplasty in patients with and without repair of the subscapularis. J Shoulder Elbow Surg 2012; 21 (01) 36-41
- 20 Langer JS, Sueoka SS, Wang AA. The importance of shoulder external rotation in activities of daily living: improving outcomes in traumatic brachial plexus palsy. J Hand Surg Am 2012; 37 (07) 1430-1436
- 21 Friedman RJ, Flurin PH, Wright TW, Zuckerman JD, Roche CP. Comparison of reverse total shoulder arthroplasty outcomes with and without subscapularis repair. J Shoulder Elbow Surg 2017; 26 (04) 662-668
- 22 Lindberg-Larsen M, Joergensen CC, Husted H, Kehlet H. Simultaneous and staged bilateral total hip arthroplasty: a Danish nationwide study. Arch Orthop Trauma Surg 2013; 133 (11) 1601-1605
- 23 Chua HS, Whitehouse SL, Lorimer M, De Steiger R, Guo L, Crawford RW. Mortality and implant survival with simultaneous and staged bilateral total knee arthroplasty experience from the Australian Orthopaedic Association National Joint Replacement Registry. J Arthroplasty 2018; 33 (10) 3167-3173