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Design Analysis: Modular Reverse Total Shoulder Prosthetic Failure Without Proximal Bone Support

[+] Author Affiliations
Farzana Ansari, Carol Major, Lisa Pruitt

University of California, Berkeley, Berkeley, CA

Stephen B. Gunther

Martha Jefferson Hospital, Charlottesville, VA

Tom R. Norris

San Francisco Shoulder, Elbow and Hand Clinic, San Francisco, CA

Michael Ries

University of California, San Francisco, San Francisco, CA

Paper No. SBC2013-14293, pp. V01AT20A014; 2 pages
  • ASME 2013 Summer Bioengineering Conference
  • Volume 1A: Abdominal Aortic Aneurysms; Active and Reactive Soft Matter; Atherosclerosis; BioFluid Mechanics; Education; Biotransport Phenomena; Bone, Joint and Spine Mechanics; Brain Injury; Cardiac Mechanics; Cardiovascular Devices, Fluids and Imaging; Cartilage and Disc Mechanics; Cell and Tissue Engineering; Cerebral Aneurysms; Computational Biofluid Dynamics; Device Design, Human Dynamics, and Rehabilitation; Drug Delivery and Disease Treatment; Engineered Cellular Environments
  • Sunriver, Oregon, USA, June 26–29, 2013
  • Conference Sponsors: Bioengineering Division
  • ISBN: 978-0-7918-5560-7
  • Copyright © 2013 by ASME


Reverse total shoulder arthroplasty (RSA) serves as an effective alternative to total shoulder arthroplasty (TSA), especially for patients with rotator cuff deficiency [1]. Long-term performance of RSA has been limited by a variety of complications including dislocation, infection, humeral fracture, glenoid loosening, glenoid unscrewing, scapular erosion and polyethylene debris [1–2]. Dissociation between the proximal metaphyseal component and distal humeral prosthetic stem (disaphysis) in modular RSAs has been reported with low frequency (1–2%) [2]; however, cases have led to severe consequences including in vivo disassembly [3]. Most cases of unscrewing have occurred due to insufficient support for the prosthesis resulting from proximal humeral bone deficiency [4–5]. In this study, we evaluate a retrieved RSA that unscrewed and subsequently fractured in vivo in a patient with proximal bone deficiency.

Copyright © 2013 by ASME



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