Postoperative radiographic follow-up after reverse total shoulder arthroplasty (RTSA) plays an essential role in the early detection of implant-related complications and longitudinal risk stratification. However, interpretation of plain radiographs remains limited by interobserver variability and low sensitivity to subtle or progressive mechanical changes. This review was intended to survey the current evidence regarding artificial intelligence (AI) applications for postoperative plain radiograph-based assessment after RTSA, with a focus on clinical readiness, validated performance, and existing limitations. A narrative review was conducted with a specific focus on AI studies relating to shoulder arthroplasty and postoperative plain radiographic analysis. Applications outside shoulder arthroplasty or those based primarily on computed tomography were excluded. Among AI applications in RTSA imaging, implant identification and automated measurement of glenosphere orientation demonstrated the highest level of clinical readiness, with reproducible accuracy reported in multiple studies. In contrast, AI-based detection of scapular notching progression, component loosening, baseplate migration, and acromial or scapular spine stress reactions remains exploratory, with limited shoulder-specific validation. Across these domains, the principal barrier to clinical translation is not algorithmic capability but the lack of high-quality, longitudinally annotated RTSA radiographic datasets. Current AI applications in postoperative RTSA radiographs primarily serve to augment existing radiographic assessment, rather than replace established clinical interpretation. While select tasks are approaching clinical usability, broader adoption will require shoulder-specific longitudinal data, validated outcome-linked thresholds, and integration into routine clinical workflows.

Predicting the lifetime and function of orthopedic implants requires learning from failures observed in retrieved implants. This study scored mechanical and corrosion damage based on optical microscopy (OM) for 135 trunnion parts of retrieved hip implants and 106 tibial baseplates of retrieved knee implants. We used scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy to categorize the damage types. This data was correlated with implant and patient factors. Fretting, third-body wear, tribocorrosion, and biofilms were observed. Mechanically assisted corrosion, e.g., tribocorrosion, was the dominant damage mode for both hip and knee implants. The knee implant damage strongly depended on the locking mechanism of the polyethylene insert on the tibial baseplate. For the trunnion part, infection prior to or at surgery was correlated with higher SEM damage scores. Inflammatory arthritis and cemented hip implants correlated with lower SEM damage scores of the trunnion. Damage scores decreased with patient age, and increased with patient weight, body mass index, and years of implantation.

Catastrophic implant failure is a rare complication after total knee arthroplasty (TKA) that can lead to metallosis and pseudotumour formation requiring complex revision surgery. This case report describes a man in his 60s who presented with progressive knee pain, a squeaking implant and ligamentous instability 20 years post-primary TKA. Imaging demonstrated polyethylene failure, tibial baseplate breakage, extensive osteolysis and metallosis. The patient underwent a revision procedure with a distal femur replacement (DFR). Postoperatively he had no complications, re-admissions or revision surgery. At 4 years post DFR, he remained asymptomatic with excellent functional outcomes (Oxford Knee Score 45 out of 48; Forgotten Joint Score 98 out of 100). This case highlights DFR as a viable salvage option in appropriately selected patients where conventional revision TKA is not possible.

This review critically evaluates the literature on acromial stress fractures (ASFs) following reverse total shoulder arthroplasty (rTSA), with a focus on risk factors, prevention, and treatment. By synthesizing contemporary evidence and highlighting areas of ongoing debate, this review aims to provide clinicians with an updated understanding of these complications and identify priorities for future research.