Removal of the Reverse Shoulder Prosthesis

Removal for the reverse total shoulder prosthesis can present a unique set of challenges even to the most experienced shoulder surgeon. Although there have been many early cases of failure from infection and instability, the first cycle of long-term reverse prosthesis failures because of aseptic loosening and polyethylene wear have yet to occur. Despite the known high complication rate, there has been very little written about the proper management of a reverse replacement that has failed because of infection, instability, and loosening. The purpose of this study is to describe the surgical technique used to safely extract a failed reverse total shoulder prosthesis and also to highlight the extraction methods and salvage options unique to each manufacturer. After removal of the reverse replacement and conversion to hemiarthroplasty or preformed spacer, pain is routinely low, but shoulder function is poor with severe anterosuperior escape.