➤ Total shoulder arthroplasty can be associated with a multitude of complications, the most common of which include prosthetic loosening, glenohumeral instability, periprosthetic fracture, rotator cuff tears, infection, neural injury, and deltoid muscle dysfunction.➤ Glenoid component loosening has continued to be an unresolved problem. Recent advances in glenoid component design and fixation and alternatives such as biologic resurfacing with meniscal allograft tissue have demonstrated satisfactory short to mid-term results.➤ The reverse shoulder prosthesis has shown promising short-term results for the treatment of glenohumeral arthritis and massive rotator cuff tears and as a salvage procedure following failure of unconstrained total shoulder arthroplasty.

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Posterolateral rotatory instability of the knee, a poste rior rotational subluxation of the lateral tibial plateau in relation to the lateral femoral condyle, is an unusual condition. Twelve cases of acute posterolateral rotatory instability are presented with an average followup of 7.5 years after surgical repair. Clinical signs suggestive of this injury included posterolateral knee tenderness, and a contusion or abrasion over the anteromedial aspect of the tibia. Indications for operative repair in cluded a 2+ or greater varus instability of the knee at 30° flexion in association with a positive external rota tion recurvatum or posterolateral drawer test. At oper ation, the consistent finding was a tear in the arcuate ligament complex in all patients. Primary operative repair resulted in stable and func tional knees in 8 of 11 patients without evidence of degenerative joint disease at 7½ years postinjury. Roentgenographic evidence of degenerative joint dis ease was present in three patients, two of whom had some residual posterolateral laxity. Results were evaluated subjectively, objectively, and functionally. There were eight good, three fair, and no poor subjective results; eight good, two fair, and one poor objective results; and seven good, three fair and one poor functional results. The single objective and functional poor result had a deep infection postopera tively. Eight of the 11 patients participated in recreational sports following repair and no patients were limited in the activities of daily living.

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