Failed Reverse Total Shoulder Arthroplasty: What Are Our Bailouts?

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Reconstructive Surgery

Background:

• Reverse total shoulder arthroplasty (RTSA) is increasingly common for shoulder issues.
• RTSA complications are rising with expanded indications and patient populations.
• Not all RTSA failures can be addressed with revision surgery.

Purpose of the Study:

• To review the limited surgical options for failed RTSA when revision is not feasible.
• To discuss the implications of these limited revision strategies on shoulder function.

Main Methods:

• Literature review focusing on salvage procedures for failed RTSA.
• Analysis of evidence for non-revision RTSA options and their outcomes.

Main Results:

• Options for irreparable RTSA failure are restricted, primarily to resection arthroplasty or hemiarthroplasty.
• These salvage procedures offer limited functional recovery for the shoulder.
• Addressing the root cause via component revision or bone grafting is preferred when possible.

Conclusions:

• When revision RTSA is not an option, patients face limited functional outcomes with current salvage procedures.
• Further research is needed to improve outcomes for unrevisable RTSA failures.