Staged Revision Reverse Total Shoulder Arthroplasty to Functional Hemiarthroplasty With Retained Humeral Implant: A Salvage Technique

Abstract

With the increased incidence and indications for reverse total shoulder arthroplasty, the increased need for revision shoulder arthroplasty also continues to rise. Therefore, revision strategies and techniques are essential to optimize patient outcomes and preserve function, particularly in the challenges of glenoid failure, poor glenoid bone stock, and/or poor native bone quality. Because of the risk of intraoperative fracture, increased blood loss, prolonged operative time, excessive implant costs, and the high risk of complications of a humeral stem extraction and revision, extraction of a well‐fixed humeral stem may be unnecessary and undesirable. When feasible, stem retention is preferred, which can lead to reduced surgical morbidity, cost‐saving practice habits, and better patient outcomes, especially in systems lacking platform convertibility. This Technical Note expands the reconstructive salvage options in systems lacking platform convertibility through conversion of a reverse total shoulder arthroplasty to a functional hemiarthroplasty by cementing a glenosphere onto a retained, nonconvertible, stemmed humeral tray. This technique may serve as a definitive solution or, more likely, a temporary construct in select salvage and revision cases, offering joint stability and pain control while preserving articular congruency and avoiding the morbidity associated with full‐component revision.