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. 2015 Mar;8(1):98-106.
doi: 10.1007/s12178-014-9249-4.

Management of complications after revision shoulder arthroplasty

Hithem Rahmi  1 , Andrew Jawa  2
Affiliations

Management of complications after revision shoulder arthroplasty

Hithem Rahmi et al. Curr Rev Musculoskelet Med. 2015 Mar.

Abstract

Complications after revision shoulder arthroplasty are similar to those in the primary setting which include instability, fracture, bone loss, infection, nerve injury, and loosening. Unlike in the primary setting, however, the rate of complications for revisions is significantly greater and the management is more complex because of overlapping complications and limited treatment options. Furthermore, there is a paucity of evidence-based literature to direct the management options in these patients. The purposes of this review are to broadly outline the major complications that are seen in revision shoulder arthroplasty and to provide general principles on how to recognize and approach these complex cases.

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Figures

Fig. 1
Fig. 1
Case of a revision surgery for recurrent instability after hemiarthroplasty for proximal humerus fracture and attempt at allograft to the glenoid. a Presentation films with preoperative AP and axillary radiographs demonstrating a cemented hemiarthroplasty with tuberosity resorption and anterior humeral subluxation. b Revision to RSA was complicated by proximal humerus comminution after osteotomy for cemented implant extraction. Femoral strut allograft with cerclage wires and a long, cemented stem was placed. Positive cultures for P. acnes noted after 14 days of incubation with negative preoperative and intraoperative markers. c One year and d 3 years follow-up demonstrating prosthesis in good position with the incorporation of femoral strut allograft. Note the heterotopic bone formation at the inferior glenoid, but no bone loss or “notching”. e Acceptable functional results at 3 years follow-up with one out of ten pain on VAS
See this image and copyright information in PMC

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