Early atraumatic recurrent dislocation after reverse total shoulder arthroplasty despite optimal implant positioning:...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Arthroplasty Research

Background:

• Postoperative instability is a common complication of reverse total shoulder arthroplasty (RTSA).
• Recurrent dislocation after RTSA presents a significant clinical challenge with no universally accepted management strategy.
• This study addresses the complexity of early, atraumatic recurrent dislocation following RTSA.

Purpose of the Study:

• To report two rare cases of early, atraumatic recurrent dislocation after RTSA.
• To highlight the challenges in managing recurrent dislocations post-RTSA.
• To evaluate the effectiveness of open reduction and prolonged immobilization.

Main Methods:

• Retrospective review of 182 RTSAs performed between 2014 and 2023.
• Identification and detailed analysis of two patients with early, atraumatic recurrent dislocation.
• Surgical intervention involving operative reduction, polyethylene liner upsizing, and prolonged immobilization.

Main Results:

• Two patients experienced atraumatic recurrent dislocation at 2 and 3 weeks post-RTSA.
• Closed reduction was unsuccessful; operative reduction was required for both cases.
• Despite upsizing the polyethylene liner, instability persisted, necessitating open reduction and six weeks of immobilization in an abduction brace.

Conclusions:

• Early recurrent dislocation can occur after RTSA despite optimal implant positioning and intraoperative stability.
• Open reduction followed by prolonged immobilization can be a viable strategy to manage recurrent dislocations.
• This approach may help avoid more complex revision or resection arthroplasty.