Metallosis after reverse total shoulder arthroplasty
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We present a case of metallosis following a reverse total shoulder arthroplasty. To date, there have been four cases described in the literature that has found metallosis following shoulder replacement surgery: three following hemiarthroplasty and one following total shoulder arthroplasty. Our patient dislocated seven months postoperatively, and with the concern of further instability as noted on examination, the patient was taken to the operating room for glenosphere and liner exchange. During surgery, severe metallic staining was discovered in the joint as well as significant inferomedial wear to the polyethylene insert. This was likely due to instability as a result of inadequate tension on the deltoid muscle, inadequate liner size, early hypermobility, downward tilt of the glenoid, and failure to lateralize the component sufficiently. It is our hypothesis that the glenoid component articulated with the metal humeral neck due to asymmetric polyethylene wear of the humeral cup.

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