This is the largest reported series of failed shoulder arthroplasties, drawn from a prospective failure registry (SAFE). It catalogs 17 possible characteristics of an unsatisfactory arthroplasty in 282 shoulders, viewed from the patient's perspective rather than the surgeon's. The goal was to identify the features that recur among dissatisfied patients.
When a patient returns unhappy after a shoulder replacement, expect pain and stiffness rather than a dramatic complication. That reframes your workup toward component position, glenoid status, and occult infection.
This series captures failures from low-volume practices that surgeon-reported outcome series systematically miss, so it reflects real-world failure patterns better than single-surgeon cohorts.
The recurring lesson is technical: near-anatomic humeral component placement matters, because malposition drives glenohumeral malalignment and eccentric glenoid loading, which in turn correlate with glenoid erosion. In fracture cases, secure tuberosity fixation is the priority, and nonunions carry a 20-fold tuberosity failure risk.
Finally, maintain a low threshold for infection workup at revision. Hold antibiotics until cultures are taken, and remember P acnes as the classic indolent shoulder pathogen.
This is the largest reported series of failed shoulder arthroplasties, drawn from a prospective failure registry (SAFE). It catalogs 17 possible characteristics of an unsatisfactory arthroplasty in 282 shoulders, viewed from the patient's perspective rather than the surgeon's. The goal was to identify the features that recur among dissatisfied patients.
When a patient returns unhappy after a shoulder replacement, expect pain and stiffness rather than a dramatic complication. That reframes your workup toward component position, glenoid status, and occult infection.
This series captures failures from low-volume practices that surgeon-reported outcome series systematically miss, so it reflects real-world failure patterns better than single-surgeon cohorts.
The recurring lesson is technical: near-anatomic humeral component placement matters, because malposition drives glenohumeral malalignment and eccentric glenoid loading, which in turn correlate with glenoid erosion. In fracture cases, secure tuberosity fixation is the priority, and nonunions carry a 20-fold tuberosity failure risk.
Finally, maintain a low threshold for infection workup at revision. Hold antibiotics until cultures are taken, and remember P acnes as the classic indolent shoulder pathogen.