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.