Shoulder Arthroplasty

Future directions in shoulder arthroplasty

Shoulder arthroplasty has advanced immeasurably since the first shoulder replacement was implanted by Péan in 1893. Implant designs continue to evolve and improve, as do the materials from which these designs are constructed. The reverse prosthesis has gained widespread use…

Rehabilitation after shoulder arthroplasty

The goal of rehabilitation after shoulder arthroplasty is restoration of functional shoulder mobility in a timely fashion. Biologic factors impose limitations in achieving mobility after shoulder arthroplasty. Histologically, collagenous connective tissues in the shoulder (tendons, ligaments, capsule) contract after shoulder…

Results and complications

The results of revision shoulder arthroplasty are as variable as the indications for which it is performed. In general, outcomes after revision shoulder arthroplasty are less satisfactory than those after primary shoulder arthroplasty. Because of the paucity of results of…

Glenoid component

Problems with the glenoid are a common indication for revision arthroplasty. Such problems include failure of previously implanted glenoid components from total shoulder arthroplasty and osseous glenoid erosion after hemiarthroplasty. Frequently, glenoid problems involve substantial osseous compromise and require complex…

Humeral component

Reconstruction of the proximal humerus can be a very difficult aspect of revision shoulder arthroplasty. During extraction of the previous humeral stem, every effort should be made to preserve as much native proximal humeral bone as possible (see Chapter 38…

Humeral stem removal and glenoid exposure

Humeral stem removal can be simple or one of the most difficult and time-consuming aspects of revision shoulder arthroplasty. Preoperative planning becomes very important in facilitating removal of the humeral stem during revision shoulder arthroplasty. Although relatively smooth press fit…

Surgical approach

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Preoperative planning, imaging, and special tests

Revision shoulder arthroplasty is more challenging overall than primary shoulder arthroplasty. Preoperative planning for a revision arthroplasty case is critically important and is initiated as soon as revision arthroplasty is being considered; it should never be an afterthought the morning…

Indications and contraindications

Just as with hip and knee arthroplasty, as the volume of shoulder arthroplasties performed each year increases, so will the number of patients requiring revision shoulder arthroplasty. Indications for performing revision shoulder arthroplasty are variable and numerous and can include…