This week we saw two ladies with rheumatoid arthritis and osteopenia who had had reverse total shoulder arthroplasties using Grammont - style components. In the first case the glenoid component had pulled away from the bone leaving a large bony defect and the metaphyseal part of the humeral stem had become partially unscrewed from the diaphyseal part of the stem and was loose in the proximal humeral bone which had been previously fractured. The second case shows loosening of the glenoid component again with a massive glenoid bone defect. In addition the humerus has sustained two different fractures - the lower one healed and the upper one healing. Comment: As surgeons push the indications for the reverse shoulder prosthesis, it needs to be recognized that a house is only as solid as the foundation on which it is built. Revision of these cases will be extremely difficult. === Consultation for those who live a distance away from Seattle. Check out the new Shoulder Arthritis Book - click here. Click here to see the new Rotator Cuff Book To see the topics covered in this Blog, click here Use the "Search" box to the right to find other topics of interest to you. You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials' See from which cities our patients come. See the countries from which our readers come on this post. To see other similar posts, click on the label of interest below.