Lessons Learned from Failed Total Shoulder Arthroplasty Cases

    At ICJR 6th Annual Shoulder Course, Joseph D. Zuckerman, MD, from NYU Langone Health, challenged a panel of surgeons experienced in primary and revision total shoulder arthroplasty (TSA) to review the radiographs and physical findings of 7 cases of failed TSA and comment on how they would manage those patients.

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    Panel members included:

    • Jonathan C. Levy, MD, from Holy Cross Hospital, Fort Lauderdale, Florida
    • John W. Sperling, MD, MBA, from Mayo Clinic, Rochester, Minnesota
    • Howard D. Routman, DO, from Atlantis Orthopaedics in Palm Beach Gardens, Florida
    • Patrick St. Pierre, MD, from Desert Orthopedic Center, Eisenhower Medical Center, Rancho Mirage, California

    Below are the cases presented by Dr. Zuckerman.

    Case 1

    • 58-year-old male patient
    • Had undergone 2-stage revision for an infected TSA, receiving a hemiarthroplasty
    • Presents with pain and limitations to motion: 90° forward elevation, 20° external rotation

    Case 2

    • 67-year-old female patient
    • Had undergone anatomic TSA 2 years prior for osteoarthritis
    • Presents with pain and limitations to motion

    Case 3

    • 57-year-old male patient
    • Had undergone anatomic TSA 16 years prior for osteonecrosis
    • Presents with pain that had progressed over the past 2 years

    Case 4

    • 70-year-old female patient
    • Had undergone anatomic TSA 6 years prior
    • Had fallen 1 year after surgery and developed persistent pain
    • Presents with disabling shoulder pain and limitations to motion

    Case 5

    • 68-year-old female patient
    • Had undergone proximal humerus replacement 6 ½ years prior for post-traumatic arthritis
    • Had presented with erythema on the incision 4 years prior, but was lost to follow-up
    • Presents with difficulty using her upper extremity for activities of daily living due to worsening pain and decreased range of motion

    Case 6

    • 68-year-old female patient
    • Had undergone TSA for degenerative osteoarthritis 10 months prior
    • Presents with sudden onset of severe pain and limited range of motion

    Case 7

    • 79-year-old male patient
    • Under undergone anatomic TSA, and 14 months later, developed shoulder pain while doing yardwork
    • Received a subacromial steroid injection that offered some pain relief
    • Presents 26 months after surgery with increased pain and loss of motion

    Click the image above to watch the presentation and view the radiographs presented by Dr. Zuckerman.