Aims Reverse shoulder arthroplasty (RSA) has become the most common type of shoulder arthroplasty used in the UK, and a better understanding of the outcomes after revision of a failed RSA is needed. The aim of this study was to review the current evidence systematically to determine patient-reported outcome measures and the rates of re-revision and complications for patients undergoing revision of a RSA. Methods MEDLINE, Embase, CENTRAL, and the Cochrane Database of Systematic Reviews were searched. Studies involving adult patients who underwent revision of a primary RSA for any indication were included. Those who underwent a RSA for failure of a total shoulder arthroplasty or hemiarthroplasty were excluded. Pre- and postoperative shoulder scores were evaluated in a random effects meta-analysis to determine the mean difference. The rates of re-revision and complications were also calculated. Results The initial search elicited 3,166 results and, following removal of duplicates and screening, 13 studies with a total of 1,042 RSAs were identified. An increase in shoulder scores pre- to postoperatively was reported in all the studies. Following revision of a RSA to a further RSA, there was a significant increase in the American Shoulder and Elbow Surgeons Score (mean difference 20.78 (95% CI 8.16 to 33.40); p = 0.001). A re-revision rate at final follow-up ranging from 9% to 32%, a one-year re-revision rate of 14%, and a five-year re-revision rate of 23% were reported. The complication rate in all the studies was between 18.5% and 36%, with a total incidence of 29%. Conclusion This is the largest systematic review of the outcomes following revision of a RSA. We found an improvement in functional outcomes after revision surgery, but the rates of re-revision and complications are high and warrant consideration when planning a revision procedure.

中文翻译：

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初次反向肩关节置换术翻修后的结局。


目的 反向肩关节置换术 （RSA） 已成为英国最常用的肩关节置换术类型，需要更好地了解失败的 RSA 翻修后的结局。本研究的目的是系统地回顾当前证据，以确定患者报告的结果测量以及接受 RSA 翻修的患者的再翻修率和并发症发生率。方法 检索 MEDLINE 、 Embase 、 CENTRAL 和 Cochrane 系统评价数据库。纳入涉及因任何适应证接受原发性 RSA 翻修的成年患者的研究。那些因全肩关节置换术或半关节置换术失败而接受 RSA 的人被排除在外。在随机效应荟萃分析中评估术前和术后肩部评分以确定平均差异。还计算了再翻修率和并发症的发生率。结果 初步检索得出 3,166 个结果，在删除重复项和筛选后，确定了 13 项研究，共 1,042 个 RSA。所有研究均报告了术前至术后肩部评分的增加。在将 RSA 修订为进一步的 RSA 后，美国肩肘外科医生评分显著增加（均数差 20.78 （95% CI 8.16 至 33.40）;p = 0.001）。据报道，最终随访时的再翻修率为 9% 至 32%，一年再翻修率为 14%，五年再翻修率为 23%。所有研究的并发症发生率在 18.5% 至 36% 之间，总发生率为 29%。结论这是对 RSA 修订后结局的最大系统评价。 我们发现翻修手术后功能结局有所改善，但再翻修和并发症的发生率很高，在计划翻修手术时需要考虑。