Irritation of the Suprascapular Nerve during Screw Placement in the Glenoid Component Implantation in Reverse Total Shoulder Arthroplasty: A Case Report

Christopher Child, Laurenz Jaberg, Janic Fischer, JoEllen Welter and Florian Hess

Department of Orthopedic Surgery and Traumatology, Cantonal Hospital Frauenfeld, Switzerland

^*Correspondance to: Florian Hess 

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Abstract:

Background: Despite the anatomical risk of suprascapular nerve irritation following reserve shoulder arthroplasty, limited information on the development of this complication has been reported in the medical literature. Methods: In this case report, we describe a 62-year old female patient who presented with inexplicable pain one year after anatomical shoulder arthroplasty. Initial treatment involved conversion to an inverted shoulder prosthesis without changing the stem. However, her pain persisted for two additional years. Multiple diagnostic (radiological and neurological) and therapeutic examinations eventually led to the diagnosis of suprascapular nerve irritation caused by the cranial base plate screw. Results: After a positive diagnostic infiltration of the suprascapular nerve with ropivacaine, we removed the superior base plate screw and exchanged the inlay and glenosphere of the prosthesis. Two weeks after surgery, the patient was free of pain, and six weeks postoperatively, her range of motion had improved substantially. Conclusion: Implantation of RSA components, especially the posterior and superior drilling and extra osseous placement of the cranial base plate screw, risks irritating and damaging the suprascapular nerve. Surgeons ought to use the available tools, like diagnostic infiltration and CT scans, to exclude this type of adverse event when treating patients suffering from persistent postoperative pain following RSA.

Keywords:

Suprascapular nerve; Reverse total shoulder arthroplasty; Iatrogenic nerve injuries; Glenoid baseplate; Scapular notch; Complication

Cite the Article:

Child C, Jaberg L, Fischer J, Welter J, Hess F. Irritation of the Suprascapular Nerve during Screw Placement in the Glenoid Component Implantation in Reverse Total Shoulder Arthroplasty: A Case Report. World J Surg Surgical Res. 2022; 5: 1391..