BACKGROUND:
The goal of this study was to compare 2 consecutive series of 240 reverse total shoulder arthroplasties (TSA) in order to evaluate if the increase in surgeon experience modified the indications, clinical and radiographic results, and rate of complications.

MATERIAL AND METHODS:
Two hundred forty reverse TSA performed between July 2003 and March 2007 were clinically and radiographically evaluated by an independent examiner with a minimum follow-up of 2 years and compared with a previous published study (240 cases implanted by the same 2 surgeons between May 1995 and June 2003).

RESULTS:
The main etiology remained cuff tear arthropathy with an increase noted between the 2 studies. The rate of revision arthroplasty as an etiology decreased from 22.5% to 9.1%. Conversely, the rate of rheumatoid arthritis increased from 0.4% to 6.3%. The average postoperative Constant score was significantly better than the first series (66.9 vs 59.7, P < .001). The postoperative complication rate decreased with increased experience (from 19% to 10.8%), with dislocations reducing (from 7% to 3.2%), and infections reducing (from 4% to 0.9%). However, the number of nerve palsies increased. The revision rate decreased from 7.5% to 5%. The rate of glenoid notching remained stable, but the severity of notching decreased.

CONCLUSION:
Experience did not lead us to operate on younger patients, but significantly modified patient selection, results, and complications. Increased experience with the reverse shoulder arthroplasty did not reduce the rate of glenoid notching.





Polls results
1

On a scale of 1 to 10, rate how much this article will change your clinical practice?

NO change
BIG change
100% Article relates to my practice (1/1)
0% Article does not relate to my practice (0/1)
0% Undecided (0/1)
2

Will this article lead to more cost-effective healthcare?

0% Yes (0/1)
100% No (1/1)
0% Undecided (0/1)
3

Was this article biased? (commercial or personal)

0% Yes (0/1)
100% No (1/1)
0% Undecided (0/1)
4

What level of evidence do you think this article is?

0% Level 1 (0/1)
0% Level 2 (0/1)
100% Level 3 (1/1)
0% Level 4 (0/1)
0% Level 5 (0/1)