Technical considerations for revision shoulder arthroplasty

Authors

  • Valeria Cadena-De-Poortere Pontificia Universidad Javeriana, Orthopedics Department, Bogotá D.C., Colombia. https://orcid.org/0000-0002-8116-4044
  • Carlos Andrés Vásquez-Medina Pontificia Universidad Javeriana, Orthopedics Department, Bogotá D.C., Colombia. https://orcid.org/0000-0001-5531-7206
  • Daniela Gutiérrez-Zuñiga Clínica del Country, Orthopedic and Trauma Surgery Service, Bogotá D.C., Colombia.
  • Mauricio Largacha Pontificia Universidad Javeriana, Orthopedics Department, Bogotá D.C., Colombia. | Clínica del Country, Orthopedic and Trauma Surgery Service, Bogotá D.C., Colombia. https://orcid.org/0000-0001-8538-7467

DOI:

https://doi.org/10.58814/01208845.579

Keywords:

Arthroplasty, Replacement, Shoulder, Revision Surgery, Shoulder Prosthesis

Abstract

In recent decades, the frequency of shoulder arthroplasty has increased markedly. Despite advances in surgical techniques, revision rates remain between 3.9% and 9.9% and continue to pose a significant technical challenge due to bone loss and soft tissue deficiency. In this context, the objective of this article is to present the technical considerations relevant to revision shoulder arthroplasty, with particular emphasis on surgical steps that may improve outcomes and reduce complications. Strategies for exposure and removal of humeral and glenoid components are described, along with approaches to the management of humeral and glenoid bone defects, taking into account variations in approach based on defect classification and the use of bone grafts or augmented prostheses. The recommendations provided herein are supported by the available literature and the authors’ clinical experience.

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References

Sperling JW. Pearls and Tips in Shoulder Arthroplasty. Clin Orthop Surg. 2019;11(3):258-64. doi: 10.4055/cios.2019.11.3.258. PMID: 31475044; PMCID: PMC6695333.

Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). Reported Shoulders Procedures [Internet]. Australia: AOANJRR; 2025 [cited 2025 Dec 8]. Available from: https://aoanjrr.sahmri.com/shoulders.

Neubauer BE, Griffin JW. Revision Anatomic Total Shoulder Arthroplasty Surgical Technique/Tips and Tricks. Oper Tech Orthop. 2024;34(4):101148. doi: 10.1016/j.oto.2024.101148.

Goldman BH, Halpern AL, Deal MJ, Richey BP, Mason EM, Gupta HO, et al. Management of Revision Reverse Shoulder Arthroplasty. J Shoulder Elb Arthroplast. 2020; 4:1-10. doi: 10.1177/2471549220902296.

Gill DRJ, Page RS, Graves SE, Rainbird S, Hatton A. The rate of 2nd revision for shoulder arthroplasty as analyzed by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). Acta Orthop. 2021; 92(3):258-63. doi: 10.1080/17453674.2020.1871559.

Garver J, Mata-Fink A, Zhu D, Javier F, Gallacher S, Blaine TA. Revision Strategies in Reverse Total Shoulder Arthroplasty. J Shoulder Elb Arthroplast. 20171:1-10. doi: 2471549217695259.

Dines DM, Warren RF, Font-Rodriguez D. Revision Shoulder Arthroplasty. Techniques in Shoulder & Elbow Surgery. 2001;2(1):26.

Kang JR, Logli AL, Tagliero AJ, Sperling JW. The router bit extraction technique for removing a well-fixed humeral stem in revision shoulder arthroplasty. Bone Joint J. 2019;101-B(10):1280-4. doi: 10.1302/0301-620X.101B10.BJJ-2018-1592.R1. PMID: 31564150.

Taylor JR, Harmsen SM, Clark CF, Schrumpf MA, Shea KE, Kelly JD. The extended humeral osteotomy for revision shoulder arthroplasty: Results and technique. Seminars in Arthroplasty: JSES. 2020;30(2):104-10.

Van Thiel GS, Halloran JP, Twigg S, Romeo AA, Nicholson GP. The vertical humeral osteotomy for stem removal in revision shoulder arthroplasty: results and technique. J Shoulder Elbow Surg. 2011;20(8):1248-54. doi: 10.1016/j.jse.2010.12.013. PMID: 21420326.

Johnston PS, Creighton RA, Romeo AA. Humeral component revision arthroplasty: outcomes of a split osteotomy technique. J Shoulder Elbow Surg. 2012;21(4):502-6. doi: 10.1016/j.jse.2011.02.001. PMID: 21600792.

Sahota S, Sperling JW, Cofield RH. Humeral windows and longitudinal splits for component removal in revision shoulder arthroplasty. J Shoulder Elbow Surg. 2014;23(10):1485-91. doi: 10.1016/j.jse.2014.02.004. PMID: 24766791.

Elhassan B, Ozbaydar M, Higgins LD, Warner JJ. Glenoid reconstruction in revision shoulder arthroplasty. Clin Orthop Relat Res. 2008;466(3):599-607. doi: 10.1007/s11999-007-0108-0. PMID: 18213509; PMCID: PMC2505201.

Malhas A, Rashid A, Copas D, Bale S, Trail I. Glenoid bone loss in primary and revision shoulder arthroplasty. Shoulder Elbow. 2016;8(4):229-40. doi: 10.1177/1758573216648601. PMID: 27660655; PMCID: PMC5023052.

Gupta A, Thussbas C, Koch M, Seebauer L. Management of glenoid bone defects with reverse shoulder arthroplasty-surgical technique and clinical outcomes. J Shoulder Elbow Surg. 2018;27(5):853-62. doi: 10.1016/j.jse.2017.10.004. PMID: 29306665.

Ghanta RB, Tsay EL, Feeley B. Augmented baseplates in reverse shoulder arthroplasty: a systematic review of outcomes and complications. JSES Rev Rep Tech. 2023;3(1):37-43. doi: 10.1016/j.xrrt.2022.08.008. PMID: 37588067; PMCID: PMC10426546.

Ortmaier R, Wierer G, Gruber MS. Functional and Radiological Outcomes after Treatment with Custom-Made Glenoid Components in Revision Reverse Shoulder Arthroplasty. J Clin Med Res. 2022;11(3):551. doi: 10.3390/jcm11030551. PMID: 35160000; PMCID: PMC8837185.

Chalmers PN, Romeo AA, Nicholson GP, Boileau P, Keener JD, Gregory JM, et al. Humeral Bone Loss in Revision Total Shoulder Arthroplasty: the Proximal Humeral Arthroplasty Revision Osseous inSufficiency (PHAROS) Classification System. Clin Orthop Relat Res. 2019;477(2):432-41. doi: 10.1097/CORR.0000000000000590. PMID: 30601321; PMCID: PMC6370107.

McLendon PB, Cox JL, Frankle MA. Humeral bone loss in revision shoulder arthroplasty. Am J Orthop (Belle Mead NJ). 2018;47(2). doi: 10.12788/ajo.2018.0012.

Kahn T, Chalmers PN. Proximal Humeral Bone Loss in Revision Shoulder Arthroplasty. Orthop Clin North Am. 2020;51(1):87-95. doi: 10.1016/j.ocl.2019.08.003. PMID: 31739883.

Krueger VS, Santaella B, Green A, Paxton ES. Pitfalls of revision reverse replacement part II: dealing with humeral bone loss and periprosthetic fractures. Ann Jt. 2018;3:101.

Cox RM, Mandava N, Lazarus MD, Williams GR Jr, Namdari S. Management of proximal humerus bone loss with allograft prosthetic composite technique in shoulder arthroplasty. J Shoulder Elbow Surg. 2024;33(6):1306-1312. doi: 10.1016/j.jse.2023.09.038. PMID: 37981001.

Martinez AA, Bejarano C, Carbonel I, Iglesias D, Gil-Albarova J, Herrera A. The treatment of proximal humerus nonunions in older patients with reverse shoulder arthroplasty. Injury. 2012;43 Suppl 2:S3-6. doi: 10.1016/S0020-1383(13)70172-4. PMID: 23622989.

Chacon A, Virani N, Shannon R, Levy JC, Pupello D, Frankle M. Revision arthroplasty with use of a reverse shoulder prosthesis-allograft composite. J Bone Joint Surg Am. 2009;91(1):119-27. doi: 10.2106/JBJS.H.00094. PMID: 19122086.

Dolci A, Melis B, Verona M, Capone A, Marongiu G. Complications and Intraoperative Fractures in Reverse Shoulder Arthroplasty: A Systematic Review. Geriatr Orthop Surg Rehabil. 2021;12:21514593211059865. doi: 10.1177/21514593211059865. PMID: 34900387; PMCID: PMC8664304.

Himer N, Clavert P, Mellal A, Baulot E, Bauer S, Antoni M. Factors associated with humeral stem extraction difficulty in revision shoulder arthroplasty. JSES Int. 2025;9(5):1705-12. doi: 10.1016/j.jseint.2025.05.025. PMID: 41049660; PMCID: PMC12490573.

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Published

2025-12-23

How to Cite

1.
Cadena-De-Poortere V, Vásquez-Medina CA, Gutiérrez-Zuñiga D, Largacha M. Technical considerations for revision shoulder arthroplasty. Rev. Colomb. Ortop. Traumatol. [Internet]. 2025 Dec. 23 [cited 2026 Mar. 15];39:e579. Available from: https://revistasccotorg.biteca.online/index.php/rccot/article/view/579

Issue

Vol. 39 (2025)

Section

Technical Note

License

Copyright (c) 2025 The Author(s).

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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