Complications and revision of reverse total shoulder arthroplasty

The most common causes of revision surgery after reverse total shoulder arthroplasty (RTSA) are, in decreasing order: prosthetic instability (38%), infection (22%), humeral problems (21%) including loosening, unscrewing and fracture, and, lastly, problems of glenoid loosening (13%). Complications leading to reoperation are often multiple and their association is underestimated. It is not uncommon for patients to be reoperated several times due to the persistence of the same complication, failure to diagnose associated complications, or onset of an additional complication. Although it may require a number of procedures in the same patient, it is very often possible (in 90% of cases, in our experience) to conserve or replace the RTSA, allowing patients to recover a functional shoulder. However, the functional results of revised RTSA are inferior than for primary prostheses, and depend on the surgeon's experience and the number of RTSAs performed, suggesting that patients should be referred to a tertiary center.