Clin Should Elbow.
2022 Sep;25(3):244-254. 10.5397/cise.2021.00738.
Pathogenesis, Evaluation, and Management of Osteolysis After Total Shoulder Arthroplasty
- Kunze KN
1,2 - Krivicich LM3
- Brusalis C1,2
- Taylor SA1,2
- Gulotta LV1,2
- Dines JS1,2
- Fu MC1,2
- Affiliations
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- 1Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
- 2Sports Medicine Institution-Shoulder and Elbow Division, Hospital for Special Surgery, New York, NY, USA
- 3University of Illinois College of Medicine, Chicago, IL, USA
- KMID: 2535359
- DOI: http://doi.org/10.5397/cise.2021.00738
Abstract
- Radiographic osteolysis after total shoulder arthroplasty (TSA) remains a challenging clinical entity, as it may not initially manifest clinically apparent symptoms but can lead to clinically important complications, such as aseptic loosening. A thorough consideration of medical history and physical examination is essential to rule out other causes of symptomatic TSA—namely, periprosthetic joint infection—as symptoms often progress to vague pain or discomfort due to subtle component loosening. Once confirmed, nonoperative treatment of osteolysis should first be pursued given the potential to avoid surgery-associated risks. If needed, the current surgical options include glenoid polyethylene revision and conversion to reverse shoulder arthroplasty. The current article provides a comprehensive review of the evaluation and management of osteolysis after TSA through an evidence-based discussion of current concepts.
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