case_images: PMC11723734_01
case_images: Anteroposterior radiograph of the right shoulder (left) showing loosening of the glenoid component, which was confirmed by a computed tomography scan of the right shoulder without contrast. The sagittal view, taken in November 2018 (approximately 3 years post- reverse total shoulder arthroplasty), demonstrates increased perihardware lucency around the glenoid component (arrow) (right).
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case_images: F1
case_images: A repeat CT of the right shoulder without contrast demonstrated perihardware lucency involving the glenoid component raised the suspicion of either progressive loosening since the last evaluation or the presence of an infection (Fig. 1).
case_images: Anteroposterior radiograph of the right shoulder post vancomycin and tobramycin-containing antibiotic spacer placement in January 2019.
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case_images: F2
case_images: The combination of vancomycin and tobramycin is the ideal choice for antibiotic-coated cement spacers, as it covers a broad spectrum of Gram-positive and Gram-negative bacteria, and its elution is not dependent on the type of cement used (Fig. 2).
case_images: Anteroposterior radiographs of the right shoulder. 2 months post antibiotic spacer placement, demonstrating fracture through the humeral stem of the antibiotic spacer (left). Subsequently, the patient underwent successful removal of the antibiotic spacer and re-implantation of reverse total shoulder arthroplasty components in September 2020 (right).
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case_images: F3
case_images: April 2020, the patient presented with increased pain and decreased range of motion of the right shoulder after sustaining a fall. A subsequent workup revealed a fracture through the antibiotic spacer (Fig. 3).
case_images: Anteroposterior radiographs of the right shoulder in December 2020. Radiographs demonstrate loosening of the humeral stem with subsidence and dissociation of humeral cup from metaphyseal segment (left), followed by subsequent revision of the humeral component resulting in appropriate alignment (right).
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case_images: F4
case_images: In December 2020, the patient underwent a revision of the humeral component due to the loosening of the humeral stem, resulting in dissociation of the humeral baseplate from the stem (Fig. 4).
case_images: Anteroposterior radiographs of the right shoulder in February 2022 showing normal reverse total shoulder arthroplasty.
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case_images: F5
case_images: The radiographs confirmed that the prosthetic components were well-aligned (Fig. 5).