Time To Conversion of Hemi/Total Shoulder Arthroplasty To Reverse Total Shoulder Arthroplasty: A Systematic Review of Longevity and Factors Influencing Conversion

Background: The purposes of this study were to determine the average time from hemiarthroplasty (HA) or total shoulder arthroplasty (TSA) to conversion to reverse total shoulder arthroplasty (RTSA) and 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. Inclusion 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 weighted mean time to conversion of HA/TSA to RTSA was 36.8 months. Rotator cuff failure was the indication for conversion in 66% of cases (65/99), while component loosening (glenoid or humeral stem) was the indication in 14% (14/99) of cases.

Conclusions: Among patients that undergo conversion of HA/TSA to RTSA the reported time to conversion was 36.8 months on average. The most common indication for conversion to RTSA was rotator cuff failure, highlighting the importance of rotator cuff integrity when performing a primary HA or TSA.

Keywords: Shoulder, arthroplasty, total shoulder arthroplasty, reverse shoulder arthroplasty, rotator cuff tear, revision shoulder arthroplasty, conversion shoulder arthroplasty.

Abbreviations:

1.Hemiarthroplasty (HA).

2.Total shoulder arthroplasty (TSA).

3.Reverse total shoulder arthroplasty (RTSA).