# Conversion to Stemless Reverse Total Shoulder Arthroplasty After Dislocation of a Stemless Anatomic Implant in a Patient With Persistent Shoulder Instability: Case Report

## TL;DR

This case report describes a successful revision surgery converting a dislocated stemless shoulder implant to a reverse configuration, preserving bone and achieving good outcomes.

## Contribution

The first clinical and radiographic outcome report of converting a dislocated stemless anatomic implant to a stemless reverse configuration.

## Key findings

- Conversion to stemless reverse TSA preserved bone stock and reduced operative time and blood loss.
- The patient showed excellent functional outcomes and stable radiographic results at 2-year follow-up.
- This approach may be a viable option for managing instability after stemless anatomic TSA.

## Abstract

Stemless anatomic total shoulder arthroplasty (aTSA) offers bone preservation advantages in younger patients, but postoperative instability requiring revision to reverse total shoulder arthroplasty (rTSA) occurs in 20%–32% of cases, representing a major indication for revision surgery. Although stemless rTSA has demonstrated promising early outcomes in Europe since 2005, it remains investigational and not Food and Drug Administration–approved in the United States. We report a 54‐year‐old female who developed implant dislocation and subscapularis tendon failure 8 weeks after primary stemless aTSA (Sidus system, Zimmer Biomet) for primary glenohumeral osteoarthritis. Given the well‐fixed, convertible stemless humeral component and adequate metaphyseal bone quality, off‐label conversion to stemless rTSA was performed with component retention. This approach is aimed at preserving proximal humeral bone stock, reducing operative time and blood loss, and potentially decreasing infection risk. At 2‐year follow‐up, the patient demonstrated excellent functional outcomes, improved range of motion, and stable radiographic findings. To our knowledge, this is the first report describing clinical and radiographic outcomes following revision of a dislocated stemless anatomic shoulder implant to a stemless reverse configuration.