Prevention of complications in shoulder arthroplasty: understanding options and critical steps.

Total shoulder arthroplasty provides reliable pain relief of osteoarthritic shoulder pain. The keys to success with shoulder arthroplasty are adhering to appropriate indications, understanding the surgical implications of various pathologies, and applying good surgical technique. Many complications of total shoulder arthroplasty may be avoided with good preoperative preparation. Some key surgical steps that may help avoid the more common complications include proper patient positioning, adequate soft-tissue releases for rebalancing, identification of the axillary nerve, correction of glenoid version, the adjustment of humeral component size and version as needed for stability, and meticulous subscapularis repair. Additional precautions can include postoperative immobilization to protect soft-tissue repairs followed by structured rehabilitation.