These authors report on 16 patients having conversion of a failed reverse shoulder arthroplasty (RSA) to a hemiarthroplasty. All patients had insufficient bone stock for reimplantation of another RSA.
The prostheses in this series were all of the Grammont type (no glenosphere offset from the glenoid) with splayed screws that can weaken the bone at the base of the scapular spine.
The apparent indications for revision were
aseptic glenoid loosening in 7
scapular spine fracture and glenoid loosening in 4
infection in 3 (note that one Propionibacterium infection presented 8 years after the reverse!)
periprosthetic humeral fracture in 2
Postoperative functional outcome was generally poor at the latest follow-up.
Medialization progressed beyond the coracoid in 6 patients, and complete anterosuperior escape was reported in 3 patients (see below).
Three postoperative complications were recorded by the final follow-up, including 2 periprosthetic humeral fractures treated conservatively and 1 patient with painful humeral component medialization leading to resection arthroplasty.
Comment: This article deserves our attention in that with the increasing use of reverse total shoulder arthroplasty, more and more revisions will be on the horizon. While in some cases the reverse can be salvaged, infection, loss of glenoid bone stock, loss of humeral bone stock and scapular spine fractures can preclude a successful revision.
Meticulous, bone preserving surgical technique and proper prosthesis selection may help reduce the risk of reverse arthroplasty failure.
Our technique for reverse total shoulder arthroplasty is shown in this link.
Comment: This article deserves our attention in that with the increasing use of reverse total shoulder arthroplasty, more and more revisions will be on the horizon. While in some cases the reverse can be salvaged, infection, loss of glenoid bone stock, loss of humeral bone stock and scapular spine fractures can preclude a successful revision.
Meticulous, bone preserving surgical technique and proper prosthesis selection may help reduce the risk of reverse arthroplasty failure.
Our technique for reverse total shoulder arthroplasty is shown in this link.
===
Use the "Search" box to the right to find other topics of interest to you.
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
