Friday, November 2, 2018

Reverse total shoulder complications

Reverse Shoulder Arthroplasty Perioperative Considerations and Complications

These authors reviewed some recent articles on the reverse total shoulder and came to these conclusions:

(1) The most common indication for reverse total shoulder arthroplasty is primary rotator cuff tear arthropathy.
(2) Indications for reverse total shoulder arthroplasty have expanded beyond rotator cuff tear arthropathy to include other pathologies such as irreparable rotator cuff tears, glenohumeral arthritis with an intact rotator cuff, acute proximal humeral fractures, the sequelae of proximal humeral fractures, neoplasms of the proximal part of the humerus, inflammatory arthropathies, and failed total shoulder arthroplasty and hemiarthroplasty.
(3) Reverse total shoulder arthroplasty continues to have high rates of complications, which include instability, infection, scapular notching, neurologic injury, and component loosening, among others.

Different complication rates have been reported for different diagnoses.
Heres an example of scapular notching leading to glenoid baseplate failure

Here's another case of baseplate failure.

The interested reader should visit these posts as well:

(1) Reverse total shoulder - complicated by dislocation (link)

(2) 4063 complications of shoulder arthroplasty - what the literature doesn't tell us (link)

(3) Are the results of shoulder arthroplasty improving? (link)

We conclude that reverse total shoulder is a powerful tool for managing situations in which the shoulder cannot be actively elevated due to rotator cuff deficiency.

In selected shoulders with retained active elevation, other options with lower complication rates, such as a CTA arthroplasty, may be considered (see this link).

We have a new set of shoulder youtubes about the shoulder, check them out at this link.

Be sure to visit "Ream and Run - the state of the art"  regarding this radically conservative approach to shoulder arthritis at this link and 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   arthritis, total shoulder, ream and runreverse total shoulderCTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'