As shoulder arthroplasty becomes increasingly common, the burden of revision shoulder arthroplasty is also increasing. Revision reverse shoulder arthroplasty requires an understanding of the causes of failure and the evaluation of these causes and their sequelae, including infection, instability, component loosening, humeral bone loss, and glenoid bone loss. Revision reverse shoulder arthroplasty is technically complex. On the humeral side, corticotomy may be required for component removal, and bone grafting may be necessary to achieve rotational stability and to restore humeral length and avoid undertensioning and instability. On the glenoid side, bone loss is common, structural bone grafting is not infrequently required, and proper component positioning is required to avoid impingement and component loosening. Although the outcomes are generally inferior to primary reverse total shoulder arthroplasty and complications and revision surgeries are common, revision procedures still lead to notable improvements in pain, motion, and function.
From the Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT (Dr. Chalmers and Dr. Tashjian), the Department of Orthopaedic Surgery, CHU-Nice, Nice, France (Dr. Boileau), and the Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL (Dr. Romeo).
Dr. Chalmers or an immediate family member serves as a paid consultant to Mitek. Dr. Boileau or an immediate family member has received IP royalties from Wright Medical Technology; serves as a paid consultant to CONMED Linvatec and Smith & Nephew; and has stock or stock options held in Imascap. Dr. Romeo or an immediate family member has received IP royalties from Arthrex; serves as a paid consultant to Arthrex; is a member of a speakers' bureau or has made paid presentations on behalf of Arthrex; has received research or institutional support from Aesculap/B. Braun, Arthrex, Histogenics, Medipost, NuTech, OrthoSpace, Smith & Nephew, and Zimmer Biomet; and serves as a board member, owner, officer, or committee member of the American Shoulder and Elbow Surgeons, Atreon Orthopaedics, and Orthopedics Today. Dr. Tashjian or an immediate family member has received IP royalties from shoulder Innovations, Wright Medical Technology, and Zimmer Biomet; serves as a paid consultant to Cayenne Medical and Mitek; and has stock or stock options held in Conextions, INTRAFUSE, and KATOR.