Indications for reverse total shoulder arthroplasty in chronic locked shoulder dislocation: A case report and review of literature

Abstract

Reverse total shoulder arthroplasty (rTSA) is typically indicated for severe glenohumeral disease with concomitant rotator cuff insufficiency, though sparse evidence suggests positive outcomes with its use in chronic shoulder dislocation as well. We present the case of a 51-year-old male with a chronic locked anterior glenohumeral dislocation for 7 months and associated rotator cuff tear, massive engaging Hill Sachs lesion, and Bankart lesion. Several attempts at both arthroscopic and open joint repair failed, and the patient was ultimately successfully treated with rTSA. The chronicity of this patient's dislocation and severity of concomitant articular defects put him at high risk of failing native joint repair, and while these operations were still attempted, the operative surgeon would recommend rTSA first if presented with this case again. The authors believe this case lends support to the use of rTSA as a primary operative intervention in patients with chronic locked glenohumeral dislocation, though further prospective research is needed to better support this recommendation.