Academic Journal
Προβολή σε EDS

Revision reverse shoulder arthroplasty after failed shoulder arthroplasty: long-term survivorship and risk factors for failure.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Revision reverse shoulder arthroplasty after failed shoulder arthroplasty: long-term survivorship and risk factors for failure.
Συγγραφείς: Patel R; Department of Orthopaedics and Sports Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA., P Kucharik M; Department of Orthopaedics and Sports Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA., Schmidt CM 2nd; Department of Orthopaedics and Sports Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA., Kolakowski L; Florida Orthopaedic Institute, Shoulder & Elbow Service, Tampa, FL, USA., Christmas KN; Department of Translational Research, Foundation for Orthopaedic Research and Education, Tampa, FL, USA., Simon P; Department of Translational Research, Foundation for Orthopaedic Research and Education, Tampa, FL, USA; Department of Medical Engineering, University of South Florida College of Engineering & Morsani College of Medicine, Tampa, FL, USA., Frankle MA; Florida Orthopaedic Institute, Shoulder & Elbow Service, Tampa, FL, USA; Department of Orthopaedic Surgery, Tampa General Hospital, Tampa, FL, USA. Electronic address: mfrankle@floridaortho.com.
Πηγή: Journal of shoulder and elbow surgery [J Shoulder Elbow Surg] 2026 Oct; Vol. 35 (10), pp. 2346-2353. Date of Electronic Publication: 2026 Apr 24.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Mosby Country of Publication: United States NLM ID: 9206499 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-6500 (Electronic) Linking ISSN: 10582746 NLM ISO Abbreviation: J Shoulder Elbow Surg Subsets: MEDLINE
Imprint Name(s): Publication: St. Louis, MO : Mosby
Original Publication: St. Louis, MO : Mosby Yearbook, Inc., c1992-
Ιατρικοί όροι (MeSH): Reoperation*/methods , Arthroplasty, Replacement, Shoulder*/methods , Arthroplasty, Replacement, Shoulder*/adverse effects , Shoulder Joint*/surgery , Prosthesis Failure*, Humans ; Female ; Retrospective Studies ; Aged ; Male ; Risk Factors ; Middle Aged ; Treatment Failure ; Patient Reported Outcome Measures ; Time Factors
Περίληψη: Background: Reverse shoulder arthroplasty (rTSA) is increasingly used as a revision option, but long-term survivorship and patient-reported outcomes (PROs) after revision rTSA remain poorly defined. We hypothesized that revision rTSA for failed rTSA would have inferior survivorship and PROs when compared to revision rTSA for failed anatomic total shoulder arthroplasty (aTSA) or failed hemiarthroplasty (HA). Moreover, we hypothesized that shoulders undergoing secondary revision would have a higher risk of failure when compared to those undergoing first-time revision surgery.
Methods: This study is a retrospective review of a prospectively collected, single-surgeon institutional database from 2002-2022. Patients undergoing first-time revision rTSA for aseptic mechanical failure of a prior arthroplasty were included if they had ≥12 months of follow-up or required subsequent revision within 12 months. Survivorship was assessed using Kaplan-Meier analysis. PROs (American Shoulder and Elbow Surgeons [ASES] scores and satisfaction) were collected at one year, with subgroup analysis by index failed arthroplasty type: failed HA, failed aTSA, and failed rTSA. Modes of failure after secondary revision were also examined. Statistical significance was set at P < .05.
Results: Of 464 first-time revision rTSA for mechanical failure from 2002-2022, 320 revision rTSAs had appropriate follow-up and met inclusion criteria, with mean follow-up of 50.3 ± 45.7 months. Mean age was 67.4 ± 10.0 years; 54.1% were female. Overall survivorship of revision rTSA was 86.4% at 2 years and 71.4% at 10 years. In terms of survivorship stratified by index arthroplasty, the survivorship of failed HA, failed aTSA, and failed rTSA was the following: failed HA: 2-year 93.4% and 10-year 74.2%; failed aTSA: 2-year 88.6% and 10-year 82.1%; failed rTSA: 2-year 74.6% and 10-year 59.5%. Overall survivorship was inferior in shoulders revised from failed rTSA compared with failed HA or failed aTSA (P < .001). At one year, the overall cohort reported mean ASES of 61.3 ± 25.0, with 48.8% achieving Patient Acceptable Symptom State. Shoulders revised from failed rTSA had lower ASES scores (53.3 ± 26.2) than those revised from failed HA (63.3 ± 23.1) or failed aTSA (64.3 ± 25.0) (P = .008). Of the 320 revision rTSAs, 58 (18.1%) required secondary revision; mechanisms of failure included instability (5.0%), humeral loosening (4.1%), infection (4.1%), glenoid failure (3.4%), and periprosthetic fracture (1.6%). Of these, 17 (29.3%) underwent tertiary revision. Secondary revisions due to humeral loosening showed the highest hazard for tertiary failure.
Conclusion: Revision rTSA for mechanical failure demonstrates modest long-term durability and functional improvement, with more than 70% survivorship at 10 years. However, less than half of patients achieved acceptable symptom states at short-term follow-up. Specifically, revision from failed rTSA yields inferior survivorship and PROs when compared to failed aTSA or failed HA. Secondary revision procedures carried greater risk of failure, with humeral loosening remaining particularly difficult to manage. These findings highlight the need for careful patient counseling and ongoing investigation into strategies to improve survivorship after revision rTSA.
(Copyright © 2026 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)
Contributed Indexing: Keywords: Revision shoulder arthroplasty; failed revision shoulder arthroplasty; long-term outcomes; modes of failure; secondary revision; survivorship
Entry Date(s): Date Created: 20260426 Date Completed: 20260909 Latest Revision: 20260909
Update Code: 20260910
DOI: 10.1016/j.jse.2026.04.028
PMID: 42036063
Βάση Δεδομένων: MEDLINE
FullText Text:
  Availability: 0
CustomLinks:
  – Url: https://www.doi.org/10.1016/j.jse.2026.04.028?
    Name: ScienceDirect (all content) (s7799221)
    Category: fullText
    Text: View record from ScienceDirect
    MouseOverText: View record from ScienceDirect
  – Url: https://resolver.ebsco.com/c/fiv2js/result?sid=EBSCO:cmedm&genre=article&issn=15326500&ISBN=&volume=35&issue=10&date=20261001&spage=2346&pages=2346-2353&title=Journal of shoulder and elbow surgery&atitle=Revision%20reverse%20shoulder%20arthroplasty%20after%20failed%20shoulder%20arthroplasty%3A%20long-term%20survivorship%20and%20risk%20factors%20for%20failure.&aulast=Patel%20R&id=DOI:10.1016/j.jse.2026.04.028
    Name: Full Text Finder (for New FTF UI) (ns324271)
    Category: fullText
    Text: Full Text Finder
    MouseOverText: Full Text Finder
Header DbId: cmedm
DbLabel: MEDLINE
An: 42036063
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Revision reverse shoulder arthroplasty after failed shoulder arthroplasty: long-term survivorship and risk factors for failure.
– Name: Author
  Label: Authors
  Group: Au
  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Patel+R%22&quot;&gt;Patel R&lt;/searchLink&gt;; Department of Orthopaedics and Sports Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22P+Kucharik+M%22&quot;&gt;P Kucharik M&lt;/searchLink&gt;; Department of Orthopaedics and Sports Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Schmidt+CM+2nd%22&quot;&gt;Schmidt CM 2nd&lt;/searchLink&gt;; Department of Orthopaedics and Sports Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Kolakowski+L%22&quot;&gt;Kolakowski L&lt;/searchLink&gt;; Florida Orthopaedic Institute, Shoulder &amp; Elbow Service, Tampa, FL, USA.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Christmas+KN%22&quot;&gt;Christmas KN&lt;/searchLink&gt;; Department of Translational Research, Foundation for Orthopaedic Research and Education, Tampa, FL, USA.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Simon+P%22&quot;&gt;Simon P&lt;/searchLink&gt;; Department of Translational Research, Foundation for Orthopaedic Research and Education, Tampa, FL, USA; Department of Medical Engineering, University of South Florida College of Engineering &amp; Morsani College of Medicine, Tampa, FL, USA.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Frankle+MA%22&quot;&gt;Frankle MA&lt;/searchLink&gt;; Florida Orthopaedic Institute, Shoulder &amp; Elbow Service, Tampa, FL, USA; Department of Orthopaedic Surgery, Tampa General Hospital, Tampa, FL, USA. Electronic address: mfrankle@floridaortho.com.
– Name: TitleSource
  Label: Source
  Group: Src
  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%229206499%22&quot;&gt;Journal of shoulder and elbow surgery&lt;/searchLink&gt; [J Shoulder Elbow Surg] 2026 Oct; Vol. 35 (10), pp. 2346-2353. &lt;i&gt;Date of Electronic Publication: &lt;/i&gt;2026 Apr 24.
– Name: TypePub
  Label: Publication Type
  Group: TypPub
  Data: Journal Article
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: TitleSource
  Label: Journal Info
  Group: Src
  Data: &lt;i&gt;Publisher: &lt;/i&gt;&lt;searchLink fieldCode=&quot;PB&quot; term=&quot;%22Mosby%22&quot;&gt;Mosby &lt;/searchLink&gt;&lt;i&gt;Country of Publication: &lt;/i&gt;United States &lt;i&gt;NLM ID: &lt;/i&gt;9206499 &lt;i&gt;Publication Model: &lt;/i&gt;Print-Electronic &lt;i&gt;Cited Medium: &lt;/i&gt;Internet &lt;i&gt;ISSN: &lt;/i&gt;1532-6500 (Electronic) &lt;i&gt;Linking ISSN: &lt;/i&gt;&lt;searchLink fieldCode=&quot;IS&quot; term=&quot;%2210582746%22&quot;&gt;10582746 &lt;/searchLink&gt;&lt;i&gt;NLM ISO Abbreviation: &lt;/i&gt;J Shoulder Elbow Surg &lt;i&gt;Subsets: &lt;/i&gt;MEDLINE
– Name: PublisherInfo
  Label: Imprint Name(s)
  Group: PubInfo
  Data: &lt;i&gt;Publication&lt;/i&gt;: St. Louis, MO : Mosby&lt;br /&gt;&lt;i&gt;Original Publication&lt;/i&gt;: St. Louis, MO : Mosby Yearbook, Inc., c1992-
– Name: SubjectMESH
  Label: MeSH Terms
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Reoperation%22&quot;&gt;Reoperation*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Reoperation+methods%22&quot;&gt;methods&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Arthroplasty%2C+Replacement%2C+Shoulder%22&quot;&gt;Arthroplasty, Replacement, Shoulder*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Arthroplasty%2C+Replacement%2C+Shoulder+methods%22&quot;&gt;methods&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Arthroplasty%2C+Replacement%2C+Shoulder%22&quot;&gt;Arthroplasty, Replacement, Shoulder*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Arthroplasty%2C+Replacement%2C+Shoulder+adverse+effects%22&quot;&gt;adverse effects&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Shoulder+Joint%22&quot;&gt;Shoulder Joint*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Shoulder+Joint+surgery%22&quot;&gt;surgery&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Prosthesis+Failure%22&quot;&gt;Prosthesis Failure*&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Humans%22&quot;&gt;Humans&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Female%22&quot;&gt;Female&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Retrospective+Studies%22&quot;&gt;Retrospective Studies&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Aged%22&quot;&gt;Aged&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Male%22&quot;&gt;Male&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Risk+Factors%22&quot;&gt;Risk Factors&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Middle+Aged%22&quot;&gt;Middle Aged&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Treatment+Failure%22&quot;&gt;Treatment Failure&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Patient+Reported+Outcome+Measures%22&quot;&gt;Patient Reported Outcome Measures&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Time+Factors%22&quot;&gt;Time Factors&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Reverse shoulder arthroplasty (rTSA) is increasingly used as a revision option, but long-term survivorship and patient-reported outcomes (PROs) after revision rTSA remain poorly defined. We hypothesized that revision rTSA for failed rTSA would have inferior survivorship and PROs when compared to revision rTSA for failed anatomic total shoulder arthroplasty (aTSA) or failed hemiarthroplasty (HA). Moreover, we hypothesized that shoulders undergoing secondary revision would have a higher risk of failure when compared to those undergoing first-time revision surgery.&lt;br /&gt;Methods: This study is a retrospective review of a prospectively collected, single-surgeon institutional database from 2002-2022. Patients undergoing first-time revision rTSA for aseptic mechanical failure of a prior arthroplasty were included if they had ≥12 months of follow-up or required subsequent revision within 12 months. Survivorship was assessed using Kaplan-Meier analysis. PROs (American Shoulder and Elbow Surgeons [ASES] scores and satisfaction) were collected at one year, with subgroup analysis by index failed arthroplasty type: failed HA, failed aTSA, and failed rTSA. Modes of failure after secondary revision were also examined. Statistical significance was set at P &amp;lt; .05.&lt;br /&gt;Results: Of 464 first-time revision rTSA for mechanical failure from 2002-2022, 320 revision rTSAs had appropriate follow-up and met inclusion criteria, with mean follow-up of 50.3 &#177; 45.7 months. Mean age was 67.4 &#177; 10.0 years; 54.1% were female. Overall survivorship of revision rTSA was 86.4% at 2 years and 71.4% at 10 years. In terms of survivorship stratified by index arthroplasty, the survivorship of failed HA, failed aTSA, and failed rTSA was the following: failed HA: 2-year 93.4% and 10-year 74.2%; failed aTSA: 2-year 88.6% and 10-year 82.1%; failed rTSA: 2-year 74.6% and 10-year 59.5%. Overall survivorship was inferior in shoulders revised from failed rTSA compared with failed HA or failed aTSA (P &amp;lt; .001). At one year, the overall cohort reported mean ASES of 61.3 &#177; 25.0, with 48.8% achieving Patient Acceptable Symptom State. Shoulders revised from failed rTSA had lower ASES scores (53.3 &#177; 26.2) than those revised from failed HA (63.3 &#177; 23.1) or failed aTSA (64.3 &#177; 25.0) (P = .008). Of the 320 revision rTSAs, 58 (18.1%) required secondary revision; mechanisms of failure included instability (5.0%), humeral loosening (4.1%), infection (4.1%), glenoid failure (3.4%), and periprosthetic fracture (1.6%). Of these, 17 (29.3%) underwent tertiary revision. Secondary revisions due to humeral loosening showed the highest hazard for tertiary failure.&lt;br /&gt;Conclusion: Revision rTSA for mechanical failure demonstrates modest long-term durability and functional improvement, with more than 70% survivorship at 10 years. However, less than half of patients achieved acceptable symptom states at short-term follow-up. Specifically, revision from failed rTSA yields inferior survivorship and PROs when compared to failed aTSA or failed HA. Secondary revision procedures carried greater risk of failure, with humeral loosening remaining particularly difficult to manage. These findings highlight the need for careful patient counseling and ongoing investigation into strategies to improve survivorship after revision rTSA.&lt;br /&gt; (Copyright &#169; 2026 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)
– Name: SubjectMinor
  Label: Contributed Indexing
  Group:
  Data: &lt;i&gt;Keywords: &lt;/i&gt;Revision shoulder arthroplasty; failed revision shoulder arthroplasty; long-term outcomes; modes of failure; secondary revision; survivorship
– Name: DateEntry
  Label: Entry Date(s)
  Group: Date
  Data: &lt;i&gt;Date Created: &lt;/i&gt;20260426 &lt;i&gt;Date Completed: &lt;/i&gt;20260909 &lt;i&gt;Latest Revision: &lt;/i&gt;20260909
– Name: DateUpdate
  Label: Update Code
  Group: Date
  Data: 20260910
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1016/j.jse.2026.04.028
– Name: AN
  Label: PMID
  Group: ID
  Data: 42036063
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cmedm&AN=42036063
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1016/j.jse.2026.04.028
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        StartPage: 2346
    Subjects:
      – SubjectFull: Humans
        Type: general
      – SubjectFull: Female
        Type: general
      – SubjectFull: Retrospective Studies
        Type: general
      – SubjectFull: Aged
        Type: general
      – SubjectFull: Male
        Type: general
      – SubjectFull: Risk Factors
        Type: general
      – SubjectFull: Middle Aged
        Type: general
      – SubjectFull: Treatment Failure
        Type: general
      – SubjectFull: Patient Reported Outcome Measures
        Type: general
      – SubjectFull: Time Factors
        Type: general
      – SubjectFull: Reoperation methods
        Type: general
      – SubjectFull: Arthroplasty, Replacement, Shoulder methods
        Type: general
      – SubjectFull: Arthroplasty, Replacement, Shoulder adverse effects
        Type: general
      – SubjectFull: Shoulder Joint surgery
        Type: general
      – SubjectFull: Prosthesis Failure
        Type: general
    Titles:
      – TitleFull: Revision reverse shoulder arthroplasty after failed shoulder arthroplasty: long-term survivorship and risk factors for failure.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Patel R
      – PersonEntity:
          Name:
            NameFull: P Kucharik M
      – PersonEntity:
          Name:
            NameFull: Schmidt CM 2nd
      – PersonEntity:
          Name:
            NameFull: Kolakowski L
      – PersonEntity:
          Name:
            NameFull: Christmas KN
      – PersonEntity:
          Name:
            NameFull: Simon P
      – PersonEntity:
          Name:
            NameFull: Frankle MA
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 10
              Text: 2026 Oct
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-electronic
              Value: 1532-6500
          Numbering:
            – Type: volume
              Value: 35
            – Type: issue
              Value: 10
          Titles:
            – TitleFull: Journal of shoulder and elbow surgery
              Type: main
ResultId 1