What is the most common complication with RTSA resulting in re-operation?

• A. Scapular Notching
• B. Infection
• C. Dislocation
• D. Loosening

Answer: (D)

In reverse total shoulder arthroplasty, loosening of the implanted components—especially the glenoid baseplate—is the most common reason a patient needs a revision operation. The procedure relies on stable fixation of the baseplate to withstand the altered mechanics and increased forces across the shoulder joint. Over time, micromotion at the bone-implant interface and bone resorption can lead to aseptic loosening, causing pain, instability, or loss of function that necessitates re-operation to revise or exchange components. Other complications like scapular notching, infection, or dislocation can occur, but they are less frequently the direct cause of revision: notching is often radiographic and manageable without surgery, infection is serious but less common, and dislocations may be reducible or addressed with non-revision procedures.