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The following is a summary of “Humeral and Glenoid Component Malposition in Revision Shoulder Arthroplasty: A Retrospective, Cross-sectional Study,” published in the January 2025 issue of Surgery by Sperling et al.

This study aimed to evaluate the incidence of glenoid and humeral component malposition in cases of failed primary shoulder arthroplasty requiring revision surgery. The hypothesis was that the malposition of these components would be a common finding in revision surgeries for primary anatomic total shoulder arthroplasty (TSA), reverse shoulder arthroplasty (RSA), and hemiarthroplasty. A retrospective cross-sectional analysis was conducted, incorporating data from 234 consecutive cases across three institutions. Surgical and radiographic records from both the primary and revision procedures were collected and analyzed. An independent reviewer assessed the radiographs to provide an objective comparison. Descriptive statistics were presented as means with standard deviations or as frequencies. An Exact McNemar’s test was utilized to compare the frequencies of malposition reported by the independent reviewer and the institutions, with statistical significance set at p=0.05.

The quantitative review revealed that glenoid component malposition was prevalent, occurring in 51% of TSA and 93% of RSA cases when all parameters were considered. Humeral component malposition was observed in 57% of TSA, 62% of RSA, and 54% of hemiarthroplasty cases. The independent reviewer found 17% of glenoid components malpositioned in TSA cases and 54% in RSA cases, with the institutions reporting comparable rates (p=0.585). For the humeral component, the independent reviewer identified malposition in 71% of TSA, 24% of RSA, and 74% of hemiarthroplasty cases, with institutional reports aligning closely (p=0.087).

These findings indicate that component malposition is a frequent issue in revision shoulder arthroplasty cases, occurring consistently across different types of procedures. Notably, while glenoid malposition has been extensively studied, this research underscores the significant and often overlooked incidence of humeral component malposition in these revision cases. The results suggest a need for heightened awareness and meticulous surgical technique to mitigate the risk of component malposition in primary shoulder arthroplasty, ultimately reducing the likelihood of revision surgeries.

Source: sciencedirect.com/science/article/abs/pii/S1058274625000151