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Total shoulder arthroplasty: complications and revision surgery
Instructional Course Lectures
|January 1, 1990
Summary
Revision surgery for shoulder arthroplasty is uncommon but necessary for complications like loosening or infection. Successful revision requires addressing all contributing factors, often involving component revision or bone grafting.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Prosthetic shoulder arthroplasty is a common procedure for debilitating shoulder conditions.
- While generally successful, complications can necessitate revision surgery.
Purpose of the Study:
- To outline the challenges and treatment strategies for revision surgery after shoulder arthroplasty.
- To emphasize the importance of accurate diagnosis and comprehensive management of complications.
Main Methods:
- Review of potential complications leading to revision surgery.
- Discussion of treatment options for specific issues like glenoid/humeral loosening, instability, rotator cuff tears, and infection.
- Emphasis on surgical experience for accurate pre-operative assessment.
Main Results:
- Glenoid loosening often requires component revision, potentially with bone grafting for severe bone loss.
- Humeral loosening, though rare, justifies component revision.
- Conversion of hemiarthroplasty to total shoulder arthroplasty is effective for pain.
- Rotator cuff repair depends on tear chronicity and severity.
- Infection typically necessitates implant removal, with exchange procedures possible for low-grade cases.
Conclusions:
- Revision shoulder arthroplasty demands careful diagnosis and tailored treatment for diverse complications.
- Addressing all pathologies, including bone loss and soft tissue issues, is crucial for successful outcomes.
- Component revision is frequently necessary, alongside management of associated problems like instability or infection.