This is a systematic review of complications after total shoulder arthroplasty, pooling 39 studies and 2,810 replacements from 1996 to 2005. It asks whether follow-up length, complication types, and survivorship changed compared to a prior 1996 analysis. Complications are stratified by type and by anatomic component.
When you counsel a patient on total shoulder arthroplasty, the number to know is that glenoid loosening is the dominant long-term failure mode, driving most revisions. This review teaches a key mental model: radiolucent lines are common (up to 80% at 10 years) but only a fraction progress to revision (7%). Do not equate a radiolucent line with clinical failure.
Component design matters. Pegged cemented glenoids outperform keeled, and uncemented metal-backed glenoids were abandoned after mid-term osteolysis and screw breakage. Choose cemented pegged polyethylene. For OA with an intact cuff, resurface the glenoid: TSA outperforms hemiarthroplasty in pain and motion, and converting a failed hemi to TSA gives inferior results.
The reverse prosthesis is effective salvage for cuff tear arthropathy but complication-prone, so restrict it to elderly pseudoparalytic patients with adequate glenoid bone.
This is a systematic review of complications after total shoulder arthroplasty, pooling 39 studies and 2,810 replacements from 1996 to 2005. It asks whether follow-up length, complication types, and survivorship changed compared to a prior 1996 analysis. Complications are stratified by type and by anatomic component.
When you counsel a patient on total shoulder arthroplasty, the number to know is that glenoid loosening is the dominant long-term failure mode, driving most revisions. This review teaches a key mental model: radiolucent lines are common (up to 80% at 10 years) but only a fraction progress to revision (7%). Do not equate a radiolucent line with clinical failure.
Component design matters. Pegged cemented glenoids outperform keeled, and uncemented metal-backed glenoids were abandoned after mid-term osteolysis and screw breakage. Choose cemented pegged polyethylene. For OA with an intact cuff, resurface the glenoid: TSA outperforms hemiarthroplasty in pain and motion, and converting a failed hemi to TSA gives inferior results.
The reverse prosthesis is effective salvage for cuff tear arthropathy but complication-prone, so restrict it to elderly pseudoparalytic patients with adequate glenoid bone.