These authors reviewed 119 patients having reverse total shoulder finding that eleven patients (9.2%) demonstrated instability in the early postoperative period (average of 8 weeks postoperatively (range, 3 days-5 months)).
Instability was associated with male sex, history of prior open shoulder surgery, and preoperative diagnoses of fracture sequelae, proximal humeral or tuberosity nonunion and absence of subscapularis repair.
Five of the 11 patients sustained a second dislocation requiring another operation. Treatment for the initial dislocation event by placement of a thicker polyethylene insert alone was often inadequate.
Comment: Dislocation has been and remains the most frequent complication of reverse total shoulder arthroplasty (see this link).
In our experience, the management of instability after a reverse total shoulder requires a careful assessment of many factors, including patient compliance, deltoid tone, unwanted contact between the humeral polyethylene and the scapula (inferiorly or posteriorly), polyethylene wear, component malposition, component loosening, posterior soft tissue tightness and infection.
Revision surgery needs to address each of these potential factors. Revision to a glenoshere with a large diameter of curvature has been useful in increasing stability.
Use the "Search" box to the right to find other topics of interest to you.
In our experience, the management of instability after a reverse total shoulder requires a careful assessment of many factors, including patient compliance, deltoid tone, unwanted contact between the humeral polyethylene and the scapula (inferiorly or posteriorly), polyethylene wear, component malposition, component loosening, posterior soft tissue tightness and infection.
Revision surgery needs to address each of these potential factors. Revision to a glenoshere with a large diameter of curvature has been useful in increasing stability.
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We have a new set of shoulder youtubes about the shoulder, check them out at this link.
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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 run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
