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Updated: Jun 5, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Instability after reverse total shoulder replacement
Robert A Gallo1, Seth C Gamradt, Christopher J Mattern
1Bone and Joint Institute, Milton S. Hershey Medical Center, Pennsylvania State University College of Medicine, Hershey, PA, USA.
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.
