Reverse shoulder allograft-prosthetic composite (APC) with an acceptable degree of complications provides significant pain relief and improves range of motion, evident from findings of a recently published article in the Journal of Shoulder and Elbow Surgery. As patients with previously failed shoulder arthroplasty with allied proximal humeral bone loss found to have restricted reconstruction alternatives and therefore investigators assessed an alternative approach, reverse shoulder allograft-prosthetic composite (APC) efficacy for managing pain and functional disability.

A total of 73 patients were treated with a reverse shoulder APC between 2002 to 2012 and had an adequate follow-up were selected and assessed for the range of motion, radiographic evidence of failure and clinical outcome scores. Two years was considered as the minimum period of follow-up. Forty-three patients had a follow-up of more than five years, and twelve had more than ten years.

The Simple Shoulder Test score and the total American Shoulder and Elbow Surgeons score improved from the baseline scores. Out of 60 patients, forty-two exhibited good to excellent outcomes, ten showed, and eight showed unsatisfactory outcomes — a range of motion raised in forward flexion and abduction. Fourteen patients needed revision at a mean of 38 months postoperatively due to humeral loosening/periprosthetic fracture/glenosphere dissociation/infection or instability. Eighty-eight per cent of the patients exhibited reoperation-free survival rate of all reconstructions at five years, 78% at ten years, and 67% beyond ten years. Radiographic evidence of humeral loosening at final follow-up was showed by ten patients and revision was required by two patients. Reverse total shoulder APC provides positive outcomes; however, the ultimate function produced is insufficient, and the patient satisfaction remains high.