Exploring Failure of Total Shoulder Arthroplasty Systems Through Implant Retrieval, Radiographic, and Clinical Data Analyses

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Retrieved clinically failed anatomic total shoulder arthroplasty (TSA) components as well as associated radiographs and medical records were analyzed in order to investigate the origins of clinical failure(s) of TSA components.


Fifty TSA systems were retrieved from 48 patients including 27 females and 21 males; components were implanted for an average of 68 months (range, 2–267). Data obtained through radiographic analysis, medical records review, and damage mode analysis of each component were performed and statistically analyzed.


Significant correlations were found between glenoid loosening and preoperative pain (r = 1.00, P < .001), humeral stem scratching and humeral loosening (Zone 1: r = .60, P < .01; Zone 2: r = .45, P = .03; Zone 3: r = .45, P = .03) , as well as glenoid damage and rotator cuff tears (r = .36, P = .02).


Wear and damage of the glenoid and humeral components, which may result from rotator cuff tearing, may lead to accelerated loosening, clinical failure, and early revision arthroplasty. Improved implant design and/or surgical indications may improve implant performance, thereby reducing the incidence of implant damage and wear, and result in improved clinical outcomes.