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Surgical exposure in revision shoulder arthroplasty

Complex and Revision Shoulder Arthroplasty: An Evidence-Based Approach to Evaluation and Management, Page: 215-223
2019
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Book Chapter Description

Revision shoulder arthroplasty is technically more demanding and inherently fraught with more complications than primary arthroplasty. This chapter will review the preoperative assessment of the painful arthroplasty to identify one of the many reasons for failure that will help direct future intervention. Once a decision to pursue revision shoulder arthroplasty has been made, we discuss the preoperative planning required to ensure all equipment and implants will be available on the day of surgery. Next, we present our preferred surgical exposure technique including deltopectoral interval development, adhesion take down, axillary nerve identification and protection, subscapularis management, humeral and glenoid exposure, and releases to accomplish improved exposure should osteotomies be required. Based on our experience, we highlight pearls that are key to successful revision shoulder arthroplasty in the setting of altered anatomy, scar tissue and adhesions, bone loss, and soft tissue deficiency.

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