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J Am Acad Orthop Surg. 2019 Jun 15;27(12):426-436. doi: 10.5435/JAAOS-D-17-00535.

Revision Reverse Shoulder Arthroplasty.

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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).


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.


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