This retrospective single-center study reviewed 441 primary reverse total shoulder arthroplasties to identify why they require revision. It reports the reasons for additional interventions and the functional outcomes of patients who were revised.
When you counsel a patient for reverse shoulder arthroplasty, instability is the complication most likely to bring them back to the operating room, and it can recur through multiple revisions.
Recognize the timing pattern: early dislocation (weeks) may respond to closed reduction, but late instability (over two years) usually reflects a mechanical problem like component height or version and needs operative revision. The deltopectoral approach used here is itself a recognized risk factor for instability compared with the superolateral approach, a testable point.
The reassuring message for patients is that even after one or more revisions, function nearly doubles as long as the prosthesis stays in place, with Constant-Murley scores rising from 23 to 46. Remember the classic RTSA trade-off this data confirms: abduction improves but active internal rotation is lost. When infection occurs, think Propionibacterium acnes first.
This retrospective single-center study reviewed 441 primary reverse total shoulder arthroplasties to identify why they require revision. It reports the reasons for additional interventions and the functional outcomes of patients who were revised.
When you counsel a patient for reverse shoulder arthroplasty, instability is the complication most likely to bring them back to the operating room, and it can recur through multiple revisions.
Recognize the timing pattern: early dislocation (weeks) may respond to closed reduction, but late instability (over two years) usually reflects a mechanical problem like component height or version and needs operative revision. The deltopectoral approach used here is itself a recognized risk factor for instability compared with the superolateral approach, a testable point.
The reassuring message for patients is that even after one or more revisions, function nearly doubles as long as the prosthesis stays in place, with Constant-Murley scores rising from 23 to 46. Remember the classic RTSA trade-off this data confirms: abduction improves but active internal rotation is lost. When infection occurs, think Propionibacterium acnes first.