Instability after reverse total shoulder replacement

Robert Gallo, Seth C. Gamradt, Christopher J. Mattern, Frank A. Cordasco, Edward V. Craig, David M. Dines, Russell F. Warren

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Background: Despite advances in technique and implant design, instability after reverse total shoulder arthroplasty remains a challenging postoperative complication. Materials and methods: We examined our institutions' first 57 reverse total shoulder arthroplasties performed during a 3-year period (2004-2006). There were 9 cases of instability, all occurring within the first 6 months after surgery. Results: All 9 patients had compromise of the subscapularis tendon at the time of initial reverse total shoulder implantation. With regard to implant positioning, 2 patients had superiorly inclined metaglenes and 3 had metaglenes positioned superior to the inferior glenoid. Each patient with a dislocation had at least 1 revision surgery, and 4 patients had underlying infection. At most recent follow-up, only 3 patients had a concentrically reduced reverse total shoulder arthroplasty in place whereas 3 remained explanted, 2 chronically dislocated, and 1 chronically subluxated. Conclusions: Early instability after reverse total shoulder arthroplasty can be related to inadequate soft tissue, inadequate deltoid tension, malpositioned implants, and/or infection, and outcomes of treatment of early instability are generally poor.

Original languageEnglish (US)
Pages (from-to)584-590
Number of pages7
JournalJournal of Shoulder and Elbow Surgery
Volume20
Issue number4
DOIs
StatePublished - Jun 1 2011

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Arthroplasty
Patient Positioning
Rotator Cuff
Infection
Reoperation
Tendons
Shoulder Replacement Arthroplasty

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Gallo, R., Gamradt, S. C., Mattern, C. J., Cordasco, F. A., Craig, E. V., Dines, D. M., & Warren, R. F. (2011). Instability after reverse total shoulder replacement. Journal of Shoulder and Elbow Surgery, 20(4), 584-590. https://doi.org/10.1016/j.jse.2010.08.028
Gallo, Robert ; Gamradt, Seth C. ; Mattern, Christopher J. ; Cordasco, Frank A. ; Craig, Edward V. ; Dines, David M. ; Warren, Russell F. / Instability after reverse total shoulder replacement. In: Journal of Shoulder and Elbow Surgery. 2011 ; Vol. 20, No. 4. pp. 584-590.
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Gallo, R, Gamradt, SC, Mattern, CJ, Cordasco, FA, Craig, EV, Dines, DM & Warren, RF 2011, 'Instability after reverse total shoulder replacement', Journal of Shoulder and Elbow Surgery, vol. 20, no. 4, pp. 584-590. https://doi.org/10.1016/j.jse.2010.08.028

Instability after reverse total shoulder replacement. / Gallo, Robert; Gamradt, Seth C.; Mattern, Christopher J.; Cordasco, Frank A.; Craig, Edward V.; Dines, David M.; Warren, Russell F.

In: Journal of Shoulder and Elbow Surgery, Vol. 20, No. 4, 01.06.2011, p. 584-590.

Research output: Contribution to journalArticle

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N2 - Background: Despite advances in technique and implant design, instability after reverse total shoulder arthroplasty remains a challenging postoperative complication. Materials and methods: We examined our institutions' first 57 reverse total shoulder arthroplasties performed during a 3-year period (2004-2006). There were 9 cases of instability, all occurring within the first 6 months after surgery. Results: All 9 patients had compromise of the subscapularis tendon at the time of initial reverse total shoulder implantation. With regard to implant positioning, 2 patients had superiorly inclined metaglenes and 3 had metaglenes positioned superior to the inferior glenoid. Each patient with a dislocation had at least 1 revision surgery, and 4 patients had underlying infection. At most recent follow-up, only 3 patients had a concentrically reduced reverse total shoulder arthroplasty in place whereas 3 remained explanted, 2 chronically dislocated, and 1 chronically subluxated. Conclusions: Early instability after reverse total shoulder arthroplasty can be related to inadequate soft tissue, inadequate deltoid tension, malpositioned implants, and/or infection, and outcomes of treatment of early instability are generally poor.

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Gallo R, Gamradt SC, Mattern CJ, Cordasco FA, Craig EV, Dines DM et al. Instability after reverse total shoulder replacement. Journal of Shoulder and Elbow Surgery. 2011 Jun 1;20(4):584-590. https://doi.org/10.1016/j.jse.2010.08.028