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Updated: Dec 30, 2025

Reverse Total Shoulder Arthroplasty
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Failed Reverse Shoulder Arthroplasty and Recommendations for Revision.

Alexander R Markes1, Edward Cheung2, C Benjamin Ma2

  • 1University of California San Francisco, School of Medicine, San Francisco, CA, USA. Alexander.Markes@ucsf.edu.

Current Reviews in Musculoskeletal Medicine
|January 21, 2020
PubMed
Summary

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The American journal of sports medicine·2025

Revision surgery for failed reverse shoulder arthroplasty (RSA) often addresses instability and infection. Evidence-based strategies focus on restoring stability and managing complications to improve outcomes in revision RSA procedures.

Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Arthroplasty

Background:

  • Reverse shoulder arthroplasty (RSA) is a common procedure for complex shoulder conditions.
  • Complications such as instability and infection frequently necessitate revision surgery.
  • Optimal management strategies for failed RSA are continually evolving.

Purpose of the Study:

  • To review the treatment of failed reverse shoulder arthroplasty (RSA).
  • To discuss evidence-based recommendations for revision surgery after RSA failure.
  • To elucidate the nuances in managing RSA complications.

Main Methods:

  • Literature review of studies on revision reverse shoulder arthroplasty.
  • Analysis of common complications including instability and infection.
Keywords:
Reverse shoulder arthroplastyReverse shoulder arthroplasty complicationsReverse shoulder arthroplasty instabilityRevision reverse shoulder arthroplastyShoulder periprosthetic joint infection

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  • Evaluation of treatment strategies for failed RSA.

    • Main Results:

    • Instability and infection are the most frequent reasons for revision RSA.
    • Instability causes include loss of compression, containment, and impingement.
    • Revision techniques involve glenosphere adjustment, constrained inserts, and humeral distalization; two-stage procedures are common for infection.

    Conclusions:

    • Effective management of failed RSA requires addressing instability and infection.
    • Restoring soft tissue tension and avoiding impingement are key to revision success.
    • Further research is needed to optimize outcomes and minimize morbidity in revision RSA.