Enrique Pereira

Ruptura irreparable del Manguito Rotador en Artroplastía de Hombro: Resolución “simple” de la complicación con Artroplastía Reversa

Rotator cuff injury in patients with anatomical total shoulder prosthesis is becoming more frequent. These cases present with the dilemma of whether to repair the rupture or make a revision towards a reverse arthroplasty. We present the case of a patient who suffered a massive rotator cuff rupture of the right shoulder, after lifting a 30-kg object, 6 months ago. Because of glenohumeral osteoarthritis, the patient underwent a modular total shoulder arthroplasty 16 months before. Given the irreparable lesion, the adequate proximal biological integration of the cemented humeral stem, and the uncemented glenoid metallic plate, a conversion to reverse shoulder arthroplasty was performed by exchanging only the modular components of the prosthesis. Postoperative evolution was favorable; the patient regained a satisfactory range of motion during rehabilitation. Universal modular prostheses offer the possibility of “simple” conversion to a reverse arthroplasty, without exchanging the humeral stem or the glenoid plate, and thus reducing the morbidity of the procedure. Key words: Shoulder; arthroplasty; rotator cuff; reverse arthroplasty.