Late glenosphere–baseplate Morse taper dissociation after reverse total shoulder arthroplasty with a patient-specific Vault Reconstruction System glenoid: a case report
Year: 2026
Type: article
Study design: Case Report
Abstract: Background Patient-specific glenoid implants permit reverse total shoulder arthroplasty (rTSA) in the setting of severe glenoid bone loss but remain dependent on the integrity of their modular connections. We report late atraumatic dissociation of the glenosphere–taper adaptor assembly from a well-fixed Comprehensive Vault Reconstruction System (VRS) baseplate. Case Presentation Approximately six years after primary rTSA, a 72-year-old man developed sudden shoulder pain and anterior swelling during a low-energy activity. Radiographs demonstrated complete dissociation at the glenosphere–baseplate Morse taper interface with maintained baseplate fixation. At revision, the VRS baseplate and fixation screws were well fixed. A new glenosphere–taper adaptor assembly could be seated onto the baseplate but failed to achieve stable Morse taper engagement. The custom baseplate therefore required removal; residual glenoid bone stock was insufficient for revision glenoid fixation, necessitating conversion to hemiarthroplasty. Manufacturer retrieval evaluation demonstrated wear and taper damage without identifying a definitive root cause. Conclusion Late modular taper failure can occur despite durable fixation of a patient-specific glenoid baseplate and may render an otherwise well-fixed reconstruction unsalvageable. Revision planning should anticipate possible baseplate extraction and the need for salvage reconstruction.
Institutions: University of Minnesota, Henry Ford Health
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,000
OpenAlex ID: W7214072511