Revision Reverse Total Shoulder Arthroplasty Combined With Secondary Pectoralis Major Transfer for Tray-Taper...

Reverse total shoulder arthroplasty (RTSA) has become a pivotal intervention for managing rotator cuff arthropathy in the elderly, showing consistent improvements in pain relief and shoulder function. However, the broad spectrum of indications for RTSA is accompanied by a notable incidence of complications, prompting continuous advancements in technology and surgical techniques.

This case report presents an uncommon complication rarely discussed in the existing literature - humeral tray-taper breakage after RTSA. The patient, a 68-year-old with a history of rotator cuff repair surgery, underwent RTSA with concurrent subscapularis repair due to rotator cuff arthropathy. Postoperatively, the patient gradually reported weakness in internal rotation (IR), leading to a subsequent secondary pectoralis major (PM) transfer. However, following an incident where the patient experienced acute pain due to a slip, a tray-taper breakage in the implant was revealed. To address the broken implant and the weakness in IR, the patient underwent revision RTSA combined with the PM transfer. With a post-operative rehabilitation program, at 1 year and 6 months postoperatively, the patient demonstrated significant pain relief and improved functional outcomes.

The case report underscores the importance of recognizing and addressing rare complications associated with RTSA, providing insights into the management of humeral tray-taper breakage. Furthermore, combined PM transfer to RTSA could be a solution to weakness in IR. This case report emphasizes the need for careful consideration of potential complications and innovative solutions for optimal patient outcomes.

Case report.