Revision Reverse Total Shoulder Arthroplasty: Current Concepts and Operative Strategies

IF 0.2 Q4 ORTHOPEDICS

Operative Techniques in Orthopaedics Pub Date : 2024-12-01 DOI:10.1016/j.oto.2024.101150

Vaibhav R. Tadepalli MD , Vaya Chhabra , Pradip Ramamurti MD , Richard F. Nauert MD , Brian C. Werner MD

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引用次数: 0

Abstract

As the number of reverse total shoulder arthroplasties (rTSA) in the United States continues to increase, so will the number of revisions rTSAs conducted. Common indications for revision rTSA include instability, infection, humeral or glenoid component loosening or periprosthetic humeral fracture, and each indication for revision warrants specific preoperative management and intraoperative strategies. Accurate diagnosis and management of the patient is key, as failure to recognize the correct indication for revision may result in failure of the revision surgery. Revision rTSA is a technically challenging procedure. However, with diligent preoperative planning including serologic evaluation for infection, evaluation of bone loss and implant stability with computed tomography, anticipating need for bone grafting, and detailed identification of implanted components to plan for explantation, surgeons can avoid common pitfalls in the operating room. This review article will discuss the major indications for revision rTSA and provide insight and technical tips to assist with the surgical management of these challenging cases.

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改良逆行全肩关节置换术：当前的概念和手术策略

随着美国逆行全肩关节置换术（rTSA）的数量不断增加，逆行全肩关节置换术的翻修数量也在不断增加。rTSA翻修的常见适应症包括不稳定、感染、肱骨或肩关节部件松动或肱骨假体周围骨折，每个翻修适应症都需要特定的术前管理和术中策略。准确的诊断和患者的管理是关键，因为未能识别正确的指征翻修可能导致翻修手术的失败。修订rTSA是一个技术上具有挑战性的过程。然而，通过周密的术前计划，包括血清学评估感染、计算机断层扫描评估骨丢失和种植体稳定性、预测植骨需求、详细识别植入部件以计划植骨，外科医生可以避免手术室常见的陷阱。这篇综述文章将讨论修订rTSA的主要适应症，并提供见解和技术提示，以协助这些具有挑战性的病例的外科治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Operative Techniques in Orthopaedics ORTHOPEDICS-

CiteScore

0.40

自引率

0.00%

发文量

审稿时长

83 days

期刊介绍： Operative Techniques in Orthopaedics is an innovative, richly illustrated resource that keeps practitioners informed of significant advances in all areas of surgical management. Each issue of this atlas-style journal explores a single topic, often offering alternate approaches to the same procedure. Its current, definitive information keeps readers in the forefront of their specialty.