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Tips and Tricks in Anatomic Shoulder Arthroplasty

January 28, 2016

Contributors: Joaquin Sanchez-Sotelo, MD

Replacement of the glenohumeral joint with an anatomic prosthesis has the potential to provide pain relief, satisfactory function, and a durable reconstruction in the treatment of various shoulder conditions. However, a number of technical aspects of this procedure, if performed improperly, may lead to a poor clinical result, complications, or mechanical implant failure. Appropriate patient selection, a clear understanding of various implant features, adequate surgical exposure, meticulous bone preparation, balancing of the soft tissues, and postoperative management tailored to the patient are key elements to obtaining the best possible outcome in anatomic shoulder arthroplasty. For most surgeons, glenoid exposure, preparation, and implantation are the most demanding portions of the procedure. Obtaining adequate soft-tissue balance at the conclusion of the procedure is straightforward in some shoulders, but can be extremely difficult to achieve in others. This review summarizes a variety of tips and tricks learned or developed over time to help optimize outcomes when performing anatomic total shoulder arthroplasty.