This instructional course lecture reviews the most common complications after shoulder arthroplasty. It covers periprosthetic fractures, infection, instability, rotator cuff failure, and glenoid loosening. For each, it discusses prevalence, diagnosis, prevention, and treatment strategy.
The single most useful pattern in this lecture: an unstable or cuff-deficient anatomic shoulder replacement rarely does well with another anatomic revision, but reverse arthroplasty restores stability. When you evaluate a painful shoulder replacement, treat a loose humeral component as infected until proven otherwise.
Do not be reassured by normal CRP, ESR, and WBC. With Propionibacterium acnes the labs are usually normal and cultures turn positive late, so hold them at least a week. For periprosthetic fractures, location drives treatment. Type-B fractures at the stem tip resist nonoperative healing, while Type-C fractures distal to the tip usually unite in a brace.
Secondary cuff failure is a time-dependent problem, and preoperative fatty infiltration and superior glenoid tilt are the predictors worth screening for before surgery.
This instructional course lecture reviews the most common complications after shoulder arthroplasty. It covers periprosthetic fractures, infection, instability, rotator cuff failure, and glenoid loosening. For each, it discusses prevalence, diagnosis, prevention, and treatment strategy.
The single most useful pattern in this lecture: an unstable or cuff-deficient anatomic shoulder replacement rarely does well with another anatomic revision, but reverse arthroplasty restores stability. When you evaluate a painful shoulder replacement, treat a loose humeral component as infected until proven otherwise.
Do not be reassured by normal CRP, ESR, and WBC. With Propionibacterium acnes the labs are usually normal and cultures turn positive late, so hold them at least a week. For periprosthetic fractures, location drives treatment. Type-B fractures at the stem tip resist nonoperative healing, while Type-C fractures distal to the tip usually unite in a brace.
Secondary cuff failure is a time-dependent problem, and preoperative fatty infiltration and superior glenoid tilt are the predictors worth screening for before surgery.