Failed Reverse Total Shoulder Arthroplasty: What Are Our Bailouts?

While there has been a significant amount of recent literature surrounding RTSA, much of this literature has been aimed at improving outcomes for primary RTSA by improving glenoid placement, maximizing range of motion, etc., or improving outcomes following conversion of another surgery to RTSA [1••, 2, 3]. There has been little evidence surrounding options for failed RTSA that cannot be salvaged to a revision RTSA. These options are limited and often involve resection arthroplasty and hemiarthroplasty, although neither option provides patients with significant function of the shoulder [4, 5•]. Complications following RTSA are becoming more common as the number of RTSA continues to increase. Furthermore, as the indications for RTSA expand, the complications will continue to increase as this implant is used to tackle more difficult problems about the shoulder. When possible, the etiology of the problem with the RTSA should be addressed and may involve component revision, bone grafting, etc. When the problem cannot be solved with revision RTSA, then the patient can be converted to a hemiarthroplasty, or have a resection arthroplasty, with the understanding that their shoulder function will be limited.