Late Central Screw Breakage of a Monoblock Glenoid Baseplate Placed With Bone Graft

CASES: Three patients (61-81 years) experienced abrupt shoulder pain and functional decline more than 5 months after reverse total shoulder arthroplasty (RTSA) using a monoblock central-screw baseplate in graft-reconstructed glenoids. Imaging revealed central screw breakage with variable baseplate displacement. Two underwent successful revision with restoration of stable fixation; in the third, revision was deferred for medical comorbidities. CONCLUSION: Central screw breakage is an important marker of glenoid fixation failure after RTSA. These cases suggest an association with graft-dependent baseplate fixation, limited native bone support, and consequently late fatigue failure. Prompt diagnosis and timely management are essential.