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Revision of Reverse Total Shoulder Arthroplasty: Humeral Component

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Massive and Irreparable Rotator Cuff Tears

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Abstract

While initially developed to improve function in patients with chronic rotator cuff deficiency and because of its success, reverse total shoulder arthroplasty (RTSA) has led to expanding indications including fracture sequelae and revision of failed hemi- or total shoulder arthroplasty. Rates of complications in RSA are higher than in TSA or in hemiarthroplasty and higher in RTSA performed in a revision setting. Revision in failed shoulder arthroplasty often requires removal of the humeral component with a significant risk of fracture and bone loss.

The current RTSA literature revision was made to determine the most common complications and treatment strategies to address those complications. The most common complications leading to humeral implant revision of RTSA are instability, infection, and humeral implant loosening. Each of them presents unique technical challenges for the surgeon. Retention or replacement of a reverse prosthesis shows high patient satisfaction and far better functional outcomes than resection but may require several additional surgeries because of high rates of complications such as recurrent instability or low-grade infection. In the varied cases in which reverse components cannot be implanted, salvage options including resection arthroplasty or permanent spacer provide satisfactory pain relief but limited function.

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Authors and Affiliations

  1. Clinique de l’Union, Ramsay, Saint Jean, France

    Jean Kany

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  1. Jean Kany
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Correspondence to Jean Kany .

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Editors and Affiliations

  1. Hospital das Forças Armadas and Hospital da Luz, Porto, Portugal

    Nuno Sampaio Gomes

  2. Department of Traumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia

    Ladislav Kovačič

  3. ATOS Klinik München, Deutsches Schulterzentrum, München, Bayern, Germany

    Frank Martetschläger

  4. Department of Orthopaedics, University of Brescia, Brescia, Italy

    Giuseppe Milano

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Kany, J. (2020). Revision of Reverse Total Shoulder Arthroplasty: Humeral Component. In: Sampaio Gomes, N., Kovačič, L., Martetschläger, F., Milano, G. (eds) Massive and Irreparable Rotator Cuff Tears. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-61162-3_37

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  • DOI: https://doi.org/10.1007/978-3-662-61162-3_37

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-61161-6

  • Online ISBN: 978-3-662-61162-3

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