Alberto Rivera, MD
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The number of shoulder arthroplasty procedures is rapidly increasing. Therefore, shoulder revision is becoming a commonly performed procedure. Historically revising a hemiarthroplasty or total shoulder replacement ended up in a hemiarthoplasty, resection arthroplasty, arthrodesis or more recently reverse arthroplasty. This type of revision usually required stem removal, which could potentially lead to humeral fracture with or without the need of an osteotomy, increasing surgical time, bleeding and neural damage. Also, late complications, such as osteotomy nonunion and malunion could develop. Another important factor to take into consideration is the added cost of using additional implants such as a new stem, cement, cables or allograft in the setting of humeral stem revision. Modular implants using a platform system allows for a faster revision with fewer complications and potentially less cost.
I believe the use of modular platform in primary shoulder arthroplasty either hemi or total should be the standard of care.
In my experience, revising TSA to RSA has evolved to a more straightforward procedure with the use of modular components of the platform shoulder type. I believe the use of modular platform in primary shoulder arthroplasty either hemi or total should be the standard of care.