Complications of Reverse Shoulder Replacement

(Image: Image by, courtesy of Josh Pesavento)

Reverse Shoulder Replacement is a surgical procedure in which the shoulder joint is replaced with a prosthetic system that reverses the natural configuration to add stability and allow the deltoid muscle to power the shoulder. The procedure is usually done on older patients, who have experienced rotator cuff tears or arthropathy. As with most other surgical procedure, several complications sometimes occur.


Infection is the most common risk factor among surgical operations, and reverse shoulder replacement is no exception. The chance of contracting an infection during the replacement surgery is, however, relatively small and usually appears before you leave the hospital. If not detected, infection can show up later, sometimes even years later. If infection from another part of the body manages to infect the artificial joint, it is difficult for the immune system to fight it off.


Patients who have weak bones often risk bone fractures during the replacement surgery. The procedure requires that the humerus bone be cut at its head and reamed before the humeral stem can be attached. The glenoid is also reamed and flattened to seat the glenoid base plate. During these two parts of the surgery weak bones can fracture, but they usually are minor and heal with restricted activity.


Artificial shoulders can dislocate just as real shoulders do. The chance of this occurring is heightened right after surgery because the tissues have just begun to heal around the new joint. Dislocation can occur days, months or even years after surgery from improper movement. A physical therapist usually teaches the patient how to avoid such movements.

Nerve Damage

Because all of the major nerves that run up and down the arm and into the hands travel through the armpit are; injury is sometimes a complication of shoulder replacement surgery. Such complications are usually temporary and any damage to the nerves can be repaired or healed with time and stretching.

Blood Clots

While blood clots can occur in many different surgeries, they are more common in surgeries that go on in the upper body and arms. Blood clots can dislodge themselves and make their way to the lungs causing pulmonary embolus, chest pain and death in the most extreme cases. If blood clots are detected or suspected, the physician will put the patient on blood thinners to reduce serious complications.


Parts of the prosthetic shoulder are made of Polyethylene, a type of plastic. These plastic parts have the tendency to wear over time, expelling debris into the body. The body sees these particles as dangerous invaders and begins to attack them, which is called osteolysis. This defense mechanism inadvertently sometimes destroys bone tissue, resulting in weakened bones prone to fractures.

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