[Complications in reverse shoulder arthroplasty - causes, prevention and treatment options]

After introduction of the reverse shoulder prosthesis in the 1970 s, clinical outcome was poor. This was mostly caused by the constraint design and the lateralised centre of rotation, which caused shear forces and glenoid failure. In the 1980 s the centre of rotation was medialised and caudalised, a larger glenosphere and a neck/shaft angle of 155° were used. The clinical outcome data became better and the reverse shoulder prosthesis established as a treatment option. Initially used for symptomatic glenohumeral arthritis in combination with severe rotator cuff pathologies, the indications have been expanded. In spite of its great popularity, the reverse shoulder prosthesis is associated with higher complication rates than anatomic shoulder arthroplasties. Typical complications include scapular notching, baseplate failure, periprosthetic fractures, scapular fractures, infections, haematoma, instability and nerve leasions. Only few publications provide prevention or treatment strategies.