Total shoulder replacement, either anatomic or reverse, usually has very good and long-lasting results, but a revision surgery may occasionally be required. This may become necessary due to persistent pain, infection, stiffness, weakness due to rotator cuff failure, instability (dislocation), hardware loosening or wear, malposition or fracture.
Revision shoulder replacement surgery may involve the following:
- Impeding structures such as scar tissue are removed.
- Muscles, tendons, and ligaments that are stiff are released to improve range of motion and those that are injured may be able to be repaired.
- Ill-fitting or worn components are replaced or altered. Sometimes the original replacement may be converted from an anatomic to a reverse shoulder replacement. Sometimes all the components may need to be replace and bone grafting is often required.
- Fractures are stabilised with plates, screws, and wires.
- Infections are usually treated by debriding soft tissue (removal of dead, infected tissue) and irrigation with antibiotic solution.
- In cases of chronic infections, components may need to be removed completely and then replaced at a later date at a second operation. In these case long term intravenous antibiotics are often administered between the two procedures.
Risks and Complications of Revision Shoulder Replacement
Care is taken to protect muscular and neurovascular structures whose positions may be altered because of the previous surgery. Potential risks and complications that may occur include infection, instability, fractures of the humerus or scapula, shoulder stiffness, and damage to these blood vessels and nerves. Revision surgery is always a bigger operation with slightly more risk, and the results in general are never as good as the original surgery.