Monday, February 20, 2017

A total shoulder with a succession of failures

Recently we were asked to assume care of a man in his mid sixties.

Five years previously he'd had a total shoulder arthroplasty. Two years ago he had increasing pain and x-rays suggesting loosening of his humeral and glenoid components.

His surgeon removed these components and inserted an antibiotic spacer. The culture results from that surgery are unknown to us.

Six weeks later his surgeon performed a reverse total shoulder.

Nine months later the screws fixing the baseplate to the glenoid had failed.

Two months later he presented to us for evaluation - our x-rays showed that the glenosphere had displaced.

After lengthy discussions about the risk of another failure as well as the risk of infection, he elected to proceed with a revision requiring the combination of two implant systems.

Here's the specimen

The end of the story is yet to be told.

Our French friends have a saying, "l’abîme appelle l’abîme". It means one abyss calls another.