Abstract
Symptomatic dysfunction of rotator cuff in anatomic shoulder arthroplasty may require conversion to reverse shoulder arthroplasty (RSA). The case presented in this chapter is a failed hemiarthroplasty (HA) implanted for the treatment of proximal humerus fracture. In this scenario, the relatively high prevalence of complications related to healing of the tuberosities in anatomical position is the main cause of dysfunction of rotator cuff.
The crucial aspects of the revision RSA are dealing with osteopenic bone, determining appropriate length and version of the prosthetic components, and gaining sufficient soft tissue tension in order to provide adequate stability and function of the implant.
In some instances, modular shoulder prosthesis allows implant replacement by removal of the humeral head component without extracting the humeral stem. However, revision surgery is extremely challenging when removal of the entire humeral component is necessary. If longitudinal humeral osteotomy along the bicipital groove does not dislodge the prosthesis, pectoralis major pedicled cortical window osteotomy can be used, as shown in the present case.
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Kovacic, L. (2018). Failed Anatomical Shoulder Arthroplasty: Case Example 2. In: Milano, G., Grasso, A., Calvo, A., Brzóska, R. (eds) Management of Failed Shoulder Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-56504-9_19
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