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Related Concept Videos

Muscles of the Shoulder01:23

Muscles of the Shoulder

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The muscles surrounding the shoulder girdle, including the clavicle and scapula, primarily stabilize the scapula. This stable base allows other muscles to move the humerus effectively. Scapular movements often mirror those of the humerus and extend its range of motion. For instance, raising the arm above the head would not be feasible without simultaneous upward rotation of the scapula.
Anterior Thoracic Muscles
The anterior thoracic muscles include the serratus anterior, subclavius, and...
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Updated: Nov 13, 2025

Reverse Total Shoulder Arthroplasty
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Risk factors for instability after reverse shoulder arthroplasty.

Vincenzo Guarrella1, Mikael Chelli2, Peter Domos3

  • 1Istituto Ortopedico Galeazzi, IRCCS, Milano, Italy.

Shoulder & Elbow
|March 15, 2021
PubMed
Summary

Younger patients face higher instability risk after reverse shoulder arthroplasty. Lateralized implants offer protection, but revision surgery may lower functional outcomes.

Keywords:
BIO-RSAdeltoid tensioningdislocationhumeral lengtheningprosthetic instabilityreverse shoulder arthroplasty complication

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The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
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Area of Science:

  • Orthopedic surgery
  • Arthroplasty research
  • Biomechanical engineering

Background:

  • Postoperative instability is a complication of reverse shoulder arthroplasty.
  • Identifying risk factors and treatment outcomes is crucial for improving patient results.

Purpose of the Study:

  • To identify risk factors for postoperative instability after reverse shoulder arthroplasty.
  • To evaluate treatment modalities and outcomes for instability in a large patient cohort.

Main Methods:

  • Retrospective analysis of 1035 Grammont type reverse shoulder arthroplasties (1992-2010).
  • Inclusion of patients with bony lateralization on the glenoid side (19.9%).
  • Minimum five-year follow-up with clinical review and radiography.

Main Results:

  • Overall instability rate was 3.0% at a mean eight-year follow-up.
  • Higher instability in revision cases, younger patients, scapular notching, and tuberosity resorption.
  • Lateralized implants showed lower instability; 70% of cases required reoperation with reduced functional improvement.

Conclusions:

  • Younger patients are at increased risk for instability following Grammont reverse shoulder arthroplasty.
  • Lateralized reverse shoulder arthroplasties demonstrate a protective effect against instability.
  • Reoperation or revision surgery can restore stability but may compromise functional outcomes.