Failed Reverse Shoulder Arthroplasty: Case Example 2

  • Maristella F. Saccomanno
  • Cristina Rossi
  • Carmine Latte
  • Andrea Grasso


Early failure of total shoulder arthroplasty (TSA) is mainly due to dislocation/instability of the implant most of the time linked to new trauma or surgical errors, whereas, in the long term, major causes of revision surgery are rotator cuff insufficiency and loosening of glenoid component due to osteolysis. Polyethylene wear has been shown to be an important long-term complication after anatomic TSA. It generates plastic wear debris that is responsible for osteolysis and severe glenoid bone resorption.

This is a case report of a patient who had an early TSA failure due to polyethylene insert wear.


Total shoulder arthroplasty Failure Wear Revision Polyethylene 


  1. 1.
    Kim SH, Wise BL, Zhang Y, Szabo RM. Increasing incidence of shoulder arthroplasty in the United States. J Bone Joint Surg Am. 2011;93:2249–54. Scholar
  2. 2.
    Deshmukh AV, Koris M, Zurakowski D, Thornhill TS. Total shoulder arthroplasty: long-term survivorship, functional outcome, and quality of life. J Shoulder Elbow Surg. 2005;14:471–9. Scholar
  3. 3.
    Lo IKY, Litchfield RB, Griffin S, et al. Quality-of-life outcome following hemiarthroplasty or total shoulder arthroplasty in patients with osteoarthritis. A prospective, randomized trial. J Bone Joint Surg Am. 2005;87:2178–85. Scholar
  4. 4.
    Bohsali KI, Bois AJ, Wirth MA. Complications of shoulder arthroplasty. J Bone Joint Surg Am. 2017;99:256–69. Scholar
  5. 5.
    Chin PYK, Sperling JW, Cofield RH, Schleck C. Complications of total shoulder arthroplasty: are they fewer or different? J Shoulder Elbow Surg. 2006;15:19–22. Scholar
  6. 6.
    Gonzalez J-F, Alami GB, Baque F, et al. Complications of unconstrained shoulder prostheses. J Shoulder Elbow Surg. 2011;20:666–82. Scholar
  7. 7.
    Bansal A, Khatib ON, Zuckerman JD. Revision total joint arthroplasty: the epidemiology of 63,140 cases in New York State. J Arthroplasty. 2014;29:23–7. Scholar
  8. 8.
    Purdue PE, Koulouvaris P, Potter HG, et al. The cellular and molecular biology of periprosthetic osteolysis. Clin Orthop. 2007;454:251–61. Scholar
  9. 9.
    Hallab NJ, McAllister K, Brady M, Jarman-Smith M. Macrophage reactivity to different polymers demonstrates particle size- and material-specific reactivity: PEEK-OPTIMA(®) particles versus UHMWPE particles in the submicron, micron, and 10 micron size ranges. J Biomed Mater Res B Appl Biomater. 2012;100:480–92. Scholar
  10. 10.
    Boileau P, Moineau G, Morin-Salvo N, et al. Metal-backed glenoid implant with polyethylene insert is not a viable long-term therapeutic option. J Shoulder Elbow Surg. 2015;24:1534–43. Scholar
  11. 11.
    Cheung EV, Sperling JW, Cofield RH. Polyethylene insert exchange for wear after total shoulder arthroplasty. J Shoulder Elbow Surg. 2007;16:574–8. Scholar
  12. 12.
    Gunther SB, Graham J, Norris TR, et al. Retrieved glenoid components: a classification system for surface damage analysis. J Arthroplasty. 2002;17:95–100.CrossRefPubMedGoogle Scholar
  13. 13.
    Matsen FA, Clinton J, Lynch J, et al. Glenoid component failure in total shoulder arthroplasty. J Bone Joint Surg Am. 2008;90:885–96. Scholar
  14. 14.
    Carpenter SR, Urits I, Murthi AM. Porous metals and alternate bearing surfaces in shoulder arthroplasty. Curr Rev Musculoskelet Med. 2016;9:59–66. Scholar
  15. 15.
    Nyffeler RW, Sheikh R, Atkinson TS, et al. Effects of glenoid component version on humeral head displacement and joint reaction forces: an experimental study. J Shoulder Elbow Surg. 2006;15:625–9. Scholar
  16. 16.
    Spencer EE, Valdevit A, Kambic H, et al. The effect of humeral component anteversion on shoulder stability with glenoid component retroversion. J Bone Joint Surg Am. 2005;87:808–14. Scholar
  17. 17.
    Shapiro TA, McGarry MH, Gupta R, et al. Biomechanical effects of glenoid retroversion in total shoulder arthroplasty. J Shoulder Elbow Surg. 2007;16:S90–5. Scholar
  18. 18.
    Iannotti JP, Spencer EE, Winter U, et al. Prosthetic positioning in total shoulder arthroplasty. J Shoulder Elbow Surg. 2005;14:111S–21S. Scholar

Copyright information

© ESSKA 2018

Authors and Affiliations

  • Maristella F. Saccomanno
    • 1
    • 2
  • Cristina Rossi
    • 3
  • Carmine Latte
    • 3
  • Andrea Grasso
    • 4
  1. 1.Department of OrthopaedicsCatholic UniversityRomeItaly
  2. 2.“A. Gemelli” University HospitalRomeItaly
  3. 3.Villa Valeria ClinicRomeItaly
  4. 4.Department of OrthopaedicsCasa di Cura Villa ValeriaRomeItaly

Personalised recommendations