CC BY-NC-ND 4.0 · Joints 2019; 07(04): 188-198
DOI: 10.1055/s-0041-1730974
Review Article

Functional Outcomes of Bilateral Reverse Total Shoulder Arthroplasty: A Systematic Review

Michael-Alexander Malahias
1   3rd Orthopaedic Department, Hygeia Hospital, Athens, Greece
,
Emmanouil Brilakis
1   3rd Orthopaedic Department, Hygeia Hospital, Athens, Greece
,
Dimitrios Chytas
2   2nd Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
,
Dimitrios Gerogiannis
1   3rd Orthopaedic Department, Hygeia Hospital, Athens, Greece
,
Grigorios Avramidis
1   3rd Orthopaedic Department, Hygeia Hospital, Athens, Greece
,
Emmanouil Antonogiannakis
1   3rd Orthopaedic Department, Hygeia Hospital, Athens, Greece
› Author Affiliations
Funding None.

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.



Publication 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
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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