The Modern Reverse Shoulder Arthroplasty & an Updated Systematic Review for Each Complication: Part I

Background Globally, reverse shoulder arthroplasty (RSA) has moved away from the Grammont design to modern prosthesis designs. The purpose of this study was to provide a focused, updated systematic review for each of the most common complications of RSA by limiting each search to publications after 2010. In this part II: 1. Instability, 2. Humerus/Glenoid fracture, 3. Acromial/Scapular Spine fractures (AF/SSF), and Problems/Miscellaneous were examined. Methods Four separate PubMed database searches were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Overall, 137 studies for instability, 94 for humerus/glenoid fracture, 120 for AF/SSF, and 74 for problems/miscellaneous were included in each review, respectively. Univariate analysis was performed with Chi-square/fisher’s exact test. Results The Grammont design had a higher instability rate versus all other designs combined (4.0%, 1.3%; p= Conclusions Focused systematic reviews of recent literature with a large volume of shoulders demonstrate that using non-Grammont modern prosthesis designs, complications including instability, intraoperative humerus and glenoid fractures, and hematoma are significantly reduced compared to previous studies. As the indications continue to expand for RSA, it is imperative to accurately track the rate and types of complications in order to justify its cost and increased indications.