Instability After Reverse Shoulder Arthroplasty: Evaluation, Diagnosis, Management

To address the concurrent escalation in shoulder instability revision procedures for reverse shoulder arthroplasty (RSA), an operation that has seen significantly expanded utilization over the past two decades due to broader surgical indications and improved implant designs.

Prosthetic instability remains a prevalent and challenging complication following RSA. Current observations show a wide variance in reported dislocation rates, which are driven by a diverse array of newly identified patient, technical, and neurological risk factors. A comprehensive clinical and radiographic workup is required to identify the specific underlying etiology of prosthetic instability-such as loss of compression, loss of containment, impingement, or implant loosening. Determining this precise root cause is essential to effectively guide subsequent revision surgery and optimize patient outcomes.