Instability After Shoulder Replacement: Rockin’ & Rollin’

Instability after shoulder replacement is a rare but serious complication. Instability can be due to component malpositioning, bone deficiency, improper soft tissue balancing or soft tissue defects. Posterior glenoid wear, abnormal humeral version, humeral shortening or soft tissue deficiency such as subscapularis insufficiency can result in instability. Patients with rotator cuff deficiency may experience anterosuperior escape as well. Soft tissue balancing should be addressed at the time of surgery. It is important to recognize all of these factors so that each can be addressed at the time of revision and also to help prevent instability during primary surgery.