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Revision Replacement - When things have not gone very well the first time

No one likes to think about having a second (or more!) surgery on their shoulder. However, sometimes things just don't go well with the first replacement. Maybe the shoulder became stiff, the implants came loose, the shoulder dislocates or maybe the implants were not put in very well the first time. Over time, it is also possible for the rotator cuff to tear in an anatomic shoulder or an infection to occur. In each of these instances, a revision shoulder replacement is often the best option to improve pain and function.

The options for a good result the second time around used to be very poor. Over the past 10-15 years, the reverse replacement has changed this opinion. The design of the reverse allows surgeons to account for bone loss caused by a loose replacement, perform a replacement if the rotator cuff is torn, stabilize an unstable shoulder, regain better mobility for a stiff shoulder and better manage the infected replacement. These can be complex surgeries and require careful planning and experience. I enjoy helping patients through this difficult process. Here are a few of my recent examples:

  1. Loose and unstable anatomic shoulder replacement with very limited shoulder movement.

Revision reverse replacement and video of results

2. One stage revision for an infected anatomic replacement

Note the bone loss on the bottom of the humeral head and darker line around the implant indicating it is loose and probably infected

Revision to a reverse replacement in one stage. Many infected shoulder replacements often required 2 stages to remove the implant, clear the infection and then a second surgery to implant the new shoulder

Outcome of the revision reverse replacement. Guess which shoulder is not replaced and which shoulder had a revision.

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