This narrative review ranks the complications of reverse total shoulder arthroplasty from most to least common. It synthesizes the literature plus two personal series (111 and 230 cases) to identify risk factors, prevention, and management for each complication.
Think of RTSA complications as a ranked list you can recite: scapular notching is most common, but infection, instability, and acromial fracture are what actually threaten the result. The key mental model is that the reverse design's medialized, distalized center of rotation drives both its function and its complications. More medialization means more notching and higher acromial load.
When you suspect infection, anchor on the numbers: persistent pain, CRP over 10 mg/l, ESR over 30 mm/h, and remember P. acnes causes indolent late infections that standard cultures may miss. Glenoid loosening reverses the usual TSA teaching. Here it is rare compared to conventional TSA, so do not assume the glenoid is the weak link.
The authors stress the evidence base is heterogeneous with no standardized complication reporting, so treat single-study rates cautiously.
This narrative review ranks the complications of reverse total shoulder arthroplasty from most to least common. It synthesizes the literature plus two personal series (111 and 230 cases) to identify risk factors, prevention, and management for each complication.
Think of RTSA complications as a ranked list you can recite: scapular notching is most common, but infection, instability, and acromial fracture are what actually threaten the result. The key mental model is that the reverse design's medialized, distalized center of rotation drives both its function and its complications. More medialization means more notching and higher acromial load.
When you suspect infection, anchor on the numbers: persistent pain, CRP over 10 mg/l, ESR over 30 mm/h, and remember P. acnes causes indolent late infections that standard cultures may miss. Glenoid loosening reverses the usual TSA teaching. Here it is rare compared to conventional TSA, so do not assume the glenoid is the weak link.
The authors stress the evidence base is heterogeneous with no standardized complication reporting, so treat single-study rates cautiously.