While reverse total shoulder arthroplasty is seeing a dramatic increase in use, patients having these procedures continue to experience complications that are uncommon with anatomic total shoulder arthroplasty.

The authors of these two articles have thoroughly reviewed these complications and factors contributing to their occurrence:

Mechanical complications and fractures after reverse shoulder arthroplasty related to different design types and their rates: part I

Radiological changes, infections and neurological complications after reverse shoulder arthroplasty related to different design types and their rates: Part II

Here are a few examples from their articles:

Humeral subsidence

Medial humeral osteolysis

Baseplate failure

Heterotopic ossification

Excessive distalization with increased risk of acromial/spine fractures and nerve injury

Deltoid palsy from nerve injury

Cement extravasation

Polyethylene contact with scapular neck with polyethylene debris and scapular notching

Unwanted contact between the greater tuberosity and the acromion resulting in loss of motion and risk of acromial/spine fracture

Unwanted contact between humeral polyethylene and anterior scapula leading to loss of internal rotation

Notching and baseplate failure

Acromial fracture and notching

Dislocation

Glenosphere dissociation

Periprosthetic fracture

These three tables from their articles summarize some of the most important risk factors for complications

Comment: From the above summary, it seems that a standard length humeral stem with a 135 degree neck-shaft angle and an inlay cup inserted in 30 degrees of retroversion combined with a mildly lateralized glenosphere inserted with a small amount of inferior tilt provides a reasonable optimization of safety and function. Our technique for the reverse is shown in this link.

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Here are some videos that are of shoulder interest

Shoulder arthritis - what you need to know (see this link)

Shoulder arthritis - x-ray appearance (see this link)

The smooth and move for irreparable cuff tears (see this link)

The total shoulder arthroplasty (see this link).

The ream and run technique is shown in this link.

The cuff tear arthropathy arthroplasty (see this link).

The reverse total shoulder arthroplasty (see this link).