Instability after a reverse shoulder total is one of the more common complications.
The 56 authors in Predictors of Dislocations following Reverse Shoulder Arthroplasty – A Study by ASES Complications RSA Multicenter Research Group identified 6621 patients who had a minimum 3 month followup (mean 19.4, Range 3-84) after a reverse total shoulder (RSA), performed by 24 experienced surgeons. The study population consisted of 40% men with an average age 71.0 years. The dislocation rate was 2.1% for the entire cohort (n=138), 1.6% for primary RSAs (n=99), and 6.5% in revision RSAs.
A trauma was the cause of 23.0% of dislocations.
The study found that the risk factors for dislocation were not modifiable.
(1) Other than glenohumeral OA with an intact Rotator Cuff (e.g. Non-union of fractures, rotator Cuff Disease, and failed previous arthroplasty are all examples.
(2) Subluxations that have occurred post-operatively but not radiographically before the dislocation.
(3) male sex,
(4) trauma
The following are some examples of how to get started:
No repair of the subscapularis.
Comment:
The authors of this study did not identify any modifiable factors that could increase the risk for implant dislocation such as implant type or size, implant location ,…
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