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McDonald LS, Dines JS, Chin C, et al. Humeral Tray-Taper Failure in Modular Reverse Total Shoulder Arthroplasty. HSS J. 2015;12(1):8-12doi: 10.1007/s11420-015-9470-8.
McDonald, L. S., Dines, J. S., Chin, C., Warren, R. F., & Dines, D. M. (2016). Humeral Tray-Taper Failure in Modular Reverse Total Shoulder Arthroplasty. HSS journal : the musculoskeletal journal of Hospital for Special Surgery, 12(1), 8-12. https://doi.org/10.1007/s11420-015-9470-8
McDonald, Lucas S, et al. "Humeral Tray-Taper Failure in Modular Reverse Total Shoulder Arthroplasty." HSS journal : the musculoskeletal journal of Hospital for Special Surgery vol. 12,1 (2016): 8-12. doi: https://doi.org/10.1007/s11420-015-9470-8
McDonald LS, Dines JS, Chin C, Warren RF, Dines DM. Humeral Tray-Taper Failure in Modular Reverse Total Shoulder Arthroplasty. HSS J. 2016 Feb;12(1):8-12. doi: 10.1007/s11420-015-9470-8. Epub 2015 Oct 01. PMID: 26855621; PMCID: PMC4733694.
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HSS J. 2016 Feb;12(1):8-12. doi: 10.1007/s11420-015-9470-8. Epub 2015 Oct 01.

Humeral Tray-Taper Failure in Modular Reverse Total Shoulder Arthroplasty.

HSS journal : the musculoskeletal journal of Hospital for Special Surgery

Lucas S McDonald, Joshua S Dines, Christopher Chin, Russell F Warren, David M Dines

Affiliations

  1. Department of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.

PMID: 26855621 PMCID: PMC4733694 DOI: 10.1007/s11420-015-9470-8

Abstract

BACKGROUND: Reverse total shoulder arthroplasty (RTSA) provides reconstructive options in patients previously not candidates for total shoulder arthroplasty (TSA) or who have failed previous anatomic TSA. Revision from anatomic TSA to RTSA previously required removal of all components, a difficult and extensive procedure. Modular humeral components permit conversion from anatomic TSA to RTSA without removal of well-fixed humeral components.

QUESTIONS/PURPOSES: Our purpose is to present a case series of patients treated for the unique and not previously reported complication of humeral tray-taper failure following modular RTSA. Challenges in diagnosis and treatment are described, including the use of dynamic fluoroscopy and manufacturer-specific instruments for component revision.

METHODS: Five patients with a total of six humeral tray-taper failures were identified from 300 patients with first-generation (titanium) humeral trays over a 7-year period. Dynamic fluoroscopic evaluation aided in diagnosis in a majority of the cases. All cases have been revised to second-generation (cobalt chrome) humeral trays.

RESULTS: Average follow-up was 22 ± 23 months (range 3-60 months). One individual required a second revision for the same complication, but otherwise, no additional procedures were required. Symptom relief was obtained in all patients.

CONCLUSIONS: This case series illustrates a previously unpublished complication of humeral tray-taper junction failure following modular RTSA. Clinical and radiographic diagnosis is challenging; however, dynamic fluoroscopic evaluation permits identification of the component failure, and revision surgery results in good outcomes. We must, however, continue to evaluate what activities are recommend for patients following shoulder arthroplasty, specifically reverse total shoulder arthroplasty.

Keywords: complication; humeral tray-taper failure; modular components; reverse total shoulder arthroplasty; revision surgery

References

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