Baseplate failure in reverse shoulder arthroplasty (RSA) is a rare but potentially catastrophic complication due to poor patient outcomes and significant glenoid bone loss. The purpose of this study was to report on prevalence, causes and outcomes of revision RSA for baseplate failure or loosening.
A retrospective review of our institutional database was performed to identify all patients treated for a failed RSA from 2006-2021 that required revision to another RSA (rRSA) by a single surgeon. A total of 676 failed RSA procedures were identified and further analysis identified 46 patients (6.8%) who underwent rRSA for baseplate failure with a confirmed loose baseplate at the time of rRSA. The primary outcome was repeat failure of the reimplanted baseplate following rRSA. The mode of failure associated with baseplate failure was stratified into one of 3 groups: aseptic, septic, or traumatic. Twenty-four patients underwent primary revision, and 22 had undergone >1 previous arthroplasty undergoing re-revision. Five patients had a previous rRSA for baseplate failure by an outside surgeon. Thirty-two patients and 23 patients met criteria for secondary outcome analysis of final ASES, SST, and ROM scores at 1- and 2- year follow-up, respectively.
Three patients had repeat baseplate failure requiring re-revision (6.5%), two patients failed in 1 < year and had associated periprosthetic infection with baseplate failure and were converted to hemiarthroplasty. The third patient suffered traumatic failure at 10 years and underwent successful rRSA. ASES scores at 1- and 2- years (final mean ASES at 1-year: ASES 62.3; and 2-years: ASES 61.7). There was no significant difference in outcomes or based on mode of baseplate failure (p=0.232) or total arthroplasty burden (p=0.305) at one year. There were 13 total complications in 11 patients, 5 of which required reoperation for reasons other than baseplate failure.
rRSA for baseplate failure constituted 6.8% of all revisions performed over 15 years. The need for re-revision for recurrent baseplate failure was 3 of 46 (6.5%). Complications and reoperation rates are higher than that for primary RSA, but outcomes are comparable for revision of failed anatomic shoulder arthroplasty.

Copyright © 2023. Published by Elsevier Inc.