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Management of the Failed Arthroplasty for Proximal Humerus Fracture

Petkovic, Djuro, MD; Kovacevic, David, MD; Levine, William N., MD; Jobin, Charles M., MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: January 15, 2019 - Volume 27 - Issue 2 - p 39–49
doi: 10.5435/JAAOS-D-17-00051
Review Article

A variety of reasons exist for failure of arthroplasty performed for management of proximal humerus fracture. Revision surgery for these failures is complex and has a high likelihood of inferior outcomes compared with primary arthroplasty. Successful management requires consideration of various modes of failure including tuberosity malunion or resorption, rotator cuff deficiency, glenoid arthritis, bone loss, component loosening, stiffness, or infection. Although revision to a reverse shoulder arthroplasty is an appealing option to address instability, rotator cuff dysfunction, and glenoid arthritis, there are concerns with higher complication rates and inferior results compared with primary reverse replacement. Any treatment plan should appropriately address the cause for failure to optimize outcomes.

From the Center for Shoulder, Elbow and Sports Medicine, Department of Orthopedic Surgery, New York-Presbyterian/Columbia University Medical Center, New York, NY.

Dr. Kovacevic or an immediate family member serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons and the American Orthopaedic Association. Dr. Levine or an immediate family member serves as an unpaid consultant to Zimmer Biomet. Dr. Jobin or an immediate family member is a member of a speakers' bureau or has made paid presentations on behalf of Acumed, Wright Medical Group, and Zimmer Biomet; serves as a paid consultant to Acumed and Zimmer Biomet; and serves as a board member, owner, officer, or committee member of the American Shoulder and Elbow Surgeons. Neither Dr. Petkovic nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article.

© 2019 by American Academy of Orthopaedic Surgeons
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