{"id":5097,"date":"2024-03-12T17:09:53","date_gmt":"2024-03-12T15:09:53","guid":{"rendered":"https:\/\/drgpanagopoulos.com\/?p=5097"},"modified":"2025-05-02T16:57:09","modified_gmt":"2025-05-02T13:57:09","slug":"reverse-and-revision-shoulder-surgery","status":"publish","type":"post","link":"https:\/\/drgpanagopoulos.com\/en\/reverse-and-revision-shoulder-surgery\/","title":{"rendered":"Reverse shoulder arthroplasty | Solution to complex problems"},"content":{"rendered":"<p class=\"translation-block\"><strong>Reverse shoulder arthroplasty<\/strong>\n is a very successful operation that has become extremely popular worldwide in recent years, with very encouraging results. In reverse arthroplasty, the replacement of worn surfaces is reversed relative to normal shoulder anatomy and anatomical arthroplasty. The indications for this operation have expanded dramatically in recent years, with the result that the inversion provides a solution to many complex problems.<\/p>\n\n\n\n<div class=\"wp-block-rank-math-toc-block\" style=\"margin-top:0;margin-right:0;margin-bottom:0;margin-left:0\" id=\"rank-math-toc\"><p><strong>Table of contents<\/strong><\/p><nav><ul><li class=\"\"><a href=\"#\u03c4\u03b9-\u03b5\u03af\u03bd\u03b1\u03b9-\u03b7-\u03b1\u03bd\u03ac\u03c3\u03c4\u03c1\u03bf\u03c6\u03b7-\u03b1\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae-\u03ce\u03bc\u03bf\u03c5-\u03c6\u03b9\u03bb\u03bf\u03c3\u03bf\u03c6\u03af\u03b1\">What is reverse shoulder arthroplasty | Rationale<\/a><\/li><li class=\"\"><a href=\"#\u03b1\u03bd\u03ac\u03c3\u03c4\u03c1\u03bf\u03c6\u03b7-\u03b1\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae-\u03c0\u03bf\u03b9\u03b5\u03c2-\u03b5\u03af\u03bd\u03b1\u03b9-\u03bf\u03b9-\u03b5\u03bd\u03b4\u03b5\u03af\u03be\u03b5\u03b9\u03c2\">Reverse shoulder arthroplasty | Indications<\/a><\/li><li class=\"\"><a href=\"#\u03b1\u03bd\u03ac\u03c3\u03c4\u03c1\u03bf\u03c6\u03b7-\u03b1\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae-\u03ce\u03bc\u03bf\u03c5-\u03c6\u03c5\u03c3\u03b9\u03ba\u03bf\u03b8\u03b5\u03c1\u03b1\u03c0\u03b5\u03af\u03b1\">\u0391\u03bd\u03ac\u03c3\u03c4\u03c1\u03bf\u03c6\u03b7 \u0391\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae \u038f\u03bc\u03bf\u03c5 | \u03a6\u03c5\u03c3\u03b9\u03ba\u03bf\u03b8\u03b5\u03c1\u03b1\u03c0\u03b5\u03af\u03b1<\/a><\/li><li class=\"\"><a href=\"#\u03b1\u03bd\u03b1\u03b8\u03b5\u03ce\u03c1\u03b7\u03c3\u03b7-\u03b1\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae\u03c2-\u03ce\u03bc\u03bf\u03c5-\u03c0\u03bf\u03b9\u03b5\u03c2-\u03b5\u03af\u03bd\u03b1\u03b9-\u03bf\u03b9-\u03b1\u03b9\u03c4\u03af\u03b5\u03c2\">Revision shoulder arthroplasty | Causes<\/a><\/li><li class=\"\"><a href=\"#faq-\u03c3\u03c5\u03c7\u03bd\u03ad\u03c2-\u03b5\u03c1\u03c9\u03c4\u03ae\u03c3\u03b5\u03b9\u03c2\">FAQs - Frequently Asked Questions<\/a><\/li><\/ul><\/nav><\/div>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"\u03c4\u03b9-\u03b5\u03af\u03bd\u03b1\u03b9-\u03b7-\u03b1\u03bd\u03ac\u03c3\u03c4\u03c1\u03bf\u03c6\u03b7-\u03b1\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae-\u03ce\u03bc\u03bf\u03c5-\u03c6\u03b9\u03bb\u03bf\u03c3\u03bf\u03c6\u03af\u03b1\">What is reverse shoulder arthroplasty | Rationale<\/h2>\n\n\n\n<p class=\"translation-block\"><strong><a href=\"https:\/\/drgpanagopoulos.com\/en\/arthroplastiki-omou\/\" data-type=\"page\" data-id=\"941\" target=\"_blank\" rel=\"noreferrer noopener\">Reverse shoulder arthroplasty <\/a><\/strong> was developed in the 80s as a solution for <strong>rotator cuff arthropathy<\/strong> in older patients. Today, due to its excellent results, it has established itself as the treatment of choice not only for arthritis and rotator cuff arthropathy, but for a number of problems around the shoulder.<\/p>\n\n\n\n<div class=\"wp-block-uagb-image uagb-block-74311b93 wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-none\"><figure class=\"wp-block-uagb-image__figure\"><img loading=\"lazy\" decoding=\"async\" srcset=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Reverse-vs-Anatomic.jpg ,https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Reverse-vs-Anatomic.jpg 780w, https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Reverse-vs-Anatomic.jpg 360w\" sizes=\"auto, (max-width: 480px) 150px\" src=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Reverse-vs-Anatomic.jpg\" alt=\"\u0391\u03bd\u03ac\u03c3\u03c4\u03c1\u03bf\u03c6\u03b7 \u03b1\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae vs \u0391\u03bd\u03b1\u03c4\u03bf\u03bc\u03b9\u03ba\u03ae \u03b1\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae\" class=\"uag-image-5103\" width=\"1000\" height=\"555\" title=\"Reverse-vs-Anatomic\" role=\"img\"\/><figcaption class=\"uagb-image-caption\">Reverse vs Anatomic Shoulder Arthroplasty<\/figcaption><\/figure><\/div>\n\n\n\n<p class=\"translation-block\">The National Registries report a 10-year survival rate of reverse arthroplasty for rotator cuff arthropathy of <strong>94%<\/strong>. The increasing surgical experience with the reverse prosthesis and the subsequent reduction in complications has led in recent years to a spectacular expansion of the relevant indications. According to the Australian Joint Registry, the percentage of shoulder arthroplasties that are reverse has skyrocketed from 42.2% in 2009, to approximately 77.9% in 2018.<\/p>\n\n\n\n<p class=\"translation-block\">There are <strong>2 main types<\/strong> of <a href=\"https:\/\/drgpanagopoulos.com\/en\/arthroplastiki-omou\/\" target=\"_blank\" data-type=\"page\" data-id=\"941\" rel=\"noreferrer noopener\">shoulder arthroplasty<\/a>. <strong>Anatomic Shoulder Arthroplasty<\/strong> involves replacing the head of the humerus with a metal prosthesis and replacing the shoulder blade with a plastic prosthesis. Anatomic arthroplasty is performed in younger patients with an intact rotator cuff.<\/p>\n\n\n\n<div class=\"wp-block-uagb-image uagb-block-4ee0e91e wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-none\"><figure class=\"wp-block-uagb-image__figure\"><img loading=\"lazy\" decoding=\"async\" srcset=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/RSA-for-OA.jpg ,https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/RSA-for-OA.jpg 780w, https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/RSA-for-OA.jpg 360w\" sizes=\"auto, (max-width: 480px) 150px\" src=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/RSA-for-OA.jpg\" alt=\"\u0391\u03bd\u03ac\u03c3\u03c4\u03c1\u03bf\u03c6\u03b7 \u0391\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae \u03b3\u03b9\u03b1 \u03b1\u03c1\u03b8\u03c1\u03af\u03c4\u03b9\u03b4\u03b1\" class=\"uag-image-5105\" width=\"1200\" height=\"603\" title=\"RSA-for-OA\" role=\"img\"\/><figcaption class=\"uagb-image-caption\">rTSA for osteoarthritis<\/figcaption><\/figure><\/div>\n\n\n\n<p class=\"translation-block\"><strong>Reverse Shoulder Arthroplasty<\/strong> is performed in patients with arthritis, rotator cuff arthropathy, significant rotator cuff tears, humeral head fractures that are not amenable to internal fixation. In reverse shoulder arthroplasty, the head and concave surface (\"cup\") are positioned in reverse of normal (glenosphere on the glenoid and concave surface on the humerus).<\/p>\n\n\n\n<p class=\"translation-block\">Other types of shoulder arthroplasty include <strong>resurfacing<\/strong>, as well as shoulder <strong>hemiarthroplasty<\/strong>.<\/p>\n\n\n\n<p>In reverse arthroplasty, the replacement of worn surfaces is reversed relative to the normal anatomy of the shoulder. While anatomic arthroplasty replicates the normal anatomy, reverse arthroplasty follows a non-anatomic philosophy, with reverse replacement of worn articular surfaces. <\/p>\n\n\n\n<div class=\"wp-block-uagb-container uagb-block-b60d162e alignwide uagb-is-root-container\">\n<div class=\"wp-block-uagb-container uagb-block-cd8ae602\">\n<div class=\"wp-block-uagb-image uagb-block-aa58f158 wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-none\"><figure class=\"wp-block-uagb-image__figure\"><img loading=\"lazy\" decoding=\"async\" srcset=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Acute-fracture-RSA1.jpg ,https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Acute-fracture-RSA1.jpg 780w, https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Acute-fracture-RSA1.jpg 360w\" sizes=\"auto, (max-width: 480px) 150px\" src=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Acute-fracture-RSA1.jpg\" alt=\"\u039a\u03ac\u03c4\u03b1\u03b3\u03bc\u03b1 \u03ba\u03b5\u03c6\u03b1\u03bb\u03ae\u03c2 \u03b2\u03c1\u03b1\u03c7\u03b9\u03bf\u03bd\u03af\u03bf\u03c5\" class=\"uag-image-5109\" width=\"956\" height=\"1170\" title=\"Acute-fracture-RSA1\" role=\"img\"\/><figcaption class=\"uagb-image-caption\">Proximal Humerus Fractures<\/figcaption><\/figure><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-uagb-container uagb-block-80ca64a2\">\n<div class=\"wp-block-uagb-image uagb-block-333dbe26 wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-none\"><figure class=\"wp-block-uagb-image__figure\"><img loading=\"lazy\" decoding=\"async\" srcset=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Acute-fracture-RSA2.jpg ,https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Acute-fracture-RSA2.jpg 780w, https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Acute-fracture-RSA2.jpg 360w\" sizes=\"auto, (max-width: 480px) 150px\" src=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Acute-fracture-RSA2.jpg\" alt=\"\u0391\u03bd\u03ac\u03c3\u03c4\u03c1\u03bf\u03c6\u03b7 \u03b3\u03b9\u03b1 \u03ba\u03ac\u03c4\u03b1\u03b3\u03bc\u03b1\" class=\"uag-image-5110\" width=\"944\" height=\"972\" title=\"Acute-fracture-RSA2\" role=\"img\"\/><figcaption class=\"uagb-image-caption\">rTSA for fracture<\/figcaption><\/figure><\/div>\n<\/div>\n<\/div>\n\n\n\n<p class=\"translation-block\">The head of the humerus is replaced with a curved prosthesis (cup), while the humerus is replaced with a spherical prosthesis (glenosphere). In this way, the \"<strong>lever arm<\/strong>\" of the shoulder joint is restored, and the patient is able to raise his arm using only the deltoid, without needing the support of the rotator cuff.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"\u03b1\u03bd\u03ac\u03c3\u03c4\u03c1\u03bf\u03c6\u03b7-\u03b1\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae-\u03c0\u03bf\u03b9\u03b5\u03c2-\u03b5\u03af\u03bd\u03b1\u03b9-\u03bf\u03b9-\u03b5\u03bd\u03b4\u03b5\u03af\u03be\u03b5\u03b9\u03c2\">Reverse shoulder arthroplasty | Indications<\/h2>\n\n\n\n<p class=\"translation-block\">Given the explosion in popularity of reverse arthroplasty, it is not surprising that the <strong>indications<\/strong> for placement of this prosthesis have expanded dramatically in recent years. These indications include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li class=\"translation-block\"><a href=\"https:\/\/drgpanagopoulos.com\/en\/arthritida-omou\/\" target=\"_blank\" data-type=\"page\" data-id=\"840\" rel=\"noreferrer noopener\">Osteoarthritis<\/a><\/li>\n\n\n\n<li>Cuff arthropathy<\/li>\n\n\n\n<li class=\"translation-block\">Massive irreparable\u00a0<a href=\"https:\/\/drgpanagopoulos.com\/en\/rixi-strofikou-petalou\/\" target=\"_blank\" data-type=\"page\" data-id=\"842\" rel=\"noreferrer noopener\">rotator cuff tears<\/a><\/li>\n\n\n\n<li class=\"translation-block\">Trauma \u2013\u00a0<a href=\"https:\/\/drgpanagopoulos.com\/en\/katagma-kefalis-vrachioniou\/\" target=\"_blank\" data-type=\"page\" data-id=\"972\" rel=\"noreferrer noopener\">proximal humeral fractures<\/a>, either acutely, or secondarily.<\/li>\n\n\n\n<li>Proximal humerus fracture malunion<\/li>\n\n\n\n<li>Proximal humerus fracture nonunion<\/li>\n\n\n\n<li>Rheumatoid arthritis<\/li>\n\n\n\n<li>Avascular necrosis (AVN)<\/li>\n\n\n\n<li>Post-traumatic arthritis<\/li>\n\n\n\n<li>Failed rotator cuff repair<\/li>\n\n\n\n<li>Failed ORIF&nbsp;<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-uagb-container uagb-block-b9d9aacb alignwide uagb-is-root-container\">\n<div class=\"wp-block-uagb-container uagb-block-416c6c59\">\n<div class=\"wp-block-uagb-image uagb-block-766f2f78 wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-none\"><figure class=\"wp-block-uagb-image__figure\"><img loading=\"lazy\" decoding=\"async\" srcset=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Failed-ORIF.jpg ,https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Failed-ORIF.jpg 780w, https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Failed-ORIF.jpg 360w\" sizes=\"auto, (max-width: 480px) 150px\" src=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Failed-ORIF.jpg\" alt=\"\u0391\u03c0\u03bf\u03c4\u03c5\u03c7\u03af\u03b1 \u03bf\u03c3\u03c4\u03b5\u03bf\u03c3\u03cd\u03bd\u03b8\u03b5\u03c3\u03b7\u03c2\" class=\"uag-image-5114\" width=\"411\" height=\"326\" title=\"Failed-ORIF\" role=\"img\"\/><figcaption class=\"uagb-image-caption\">Failed ORIF<\/figcaption><\/figure><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-uagb-container uagb-block-fc938ade\">\n<div class=\"wp-block-uagb-image uagb-block-1d207743 wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-none\"><figure class=\"wp-block-uagb-image__figure\"><img loading=\"lazy\" decoding=\"async\" srcset=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Posttraumatic-arthritis.jpg ,https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Posttraumatic-arthritis.jpg 780w, https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Posttraumatic-arthritis.jpg 360w\" sizes=\"auto, (max-width: 480px) 150px\" src=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Posttraumatic-arthritis.jpg\" alt=\"\u039c\u03b5\u03c4\u03b1\u03c4\u03c1\u03b1\u03c5\u03bc\u03b1\u03c4\u03b9\u03ba\u03ae \u03b1\u03c1\u03b8\u03c1\u03af\u03c4\u03b9\u03b4\u03b1\" class=\"uag-image-5116\" width=\"416\" height=\"287\" title=\"Posttraumatic-arthritis\" role=\"img\"\/><figcaption class=\"uagb-image-caption\">Post-traumatic arthritis<\/figcaption><\/figure><\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-uagb-container uagb-block-bec21f24 alignwide uagb-is-root-container\">\n<div class=\"wp-block-uagb-container uagb-block-17f91b88\">\n<div class=\"wp-block-uagb-image uagb-block-a509ec95 wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-none\"><figure class=\"wp-block-uagb-image__figure\"><img loading=\"lazy\" decoding=\"async\" srcset=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Malunion-RSA1.jpg ,https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Malunion-RSA1.jpg 780w, https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Malunion-RSA1.jpg 360w\" sizes=\"auto, (max-width: 480px) 150px\" src=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Malunion-RSA1.jpg\" alt=\"\u03a8\u03b5\u03c5\u03b4\u03ac\u03c1\u03b8\u03c1\u03c9\u03c3\u03b7 \u03ba\u03b1\u03c4\u03ac\u03b3\u03bc\u03b1\u03c4\u03bf\u03c2 \u03ba\u03b5\u03c6\u03b1\u03bb\u03ae\u03c2 \u03b2\u03c1\u03b1\u03c7\u03b9\u03bf\u03bd\u03af\u03bf\u03c5\" class=\"uag-image-5120\" width=\"1222\" height=\"972\" title=\"Malunion-RSA1\" role=\"img\"\/><figcaption class=\"uagb-image-caption\">Proximal humerus fracture malunion<\/figcaption><\/figure><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-uagb-container uagb-block-6ec36875\">\n<div class=\"wp-block-uagb-image uagb-block-fdad1565 wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-none\"><figure class=\"wp-block-uagb-image__figure\"><img loading=\"lazy\" decoding=\"async\" srcset=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Malunion-RSA2.jpg ,https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Malunion-RSA2.jpg 780w, https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Malunion-RSA2.jpg 360w\" sizes=\"auto, (max-width: 480px) 150px\" src=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Malunion-RSA2.jpg\" alt=\"\u0391\u03bd\u03ac\u03c3\u03c4\u03c1\u03bf\u03c6\u03b7 \u03b3\u03b9\u03b1 malunion\" class=\"uag-image-5121\" width=\"1230\" height=\"1210\" title=\"Malunion-RSA2\" role=\"img\"\/><figcaption class=\"uagb-image-caption\">rTSA for malunion<\/figcaption><\/figure><\/div>\n<\/div>\n<\/div>\n\n\n\n<p><\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"\u03b1\u03bd\u03ac\u03c3\u03c4\u03c1\u03bf\u03c6\u03b7-\u03b1\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae-\u03ce\u03bc\u03bf\u03c5-\u03c6\u03c5\u03c3\u03b9\u03ba\u03bf\u03b8\u03b5\u03c1\u03b1\u03c0\u03b5\u03af\u03b1\">\u0391\u03bd\u03ac\u03c3\u03c4\u03c1\u03bf\u03c6\u03b7 \u0391\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae \u038f\u03bc\u03bf\u03c5 | \u03a6\u03c5\u03c3\u03b9\u03ba\u03bf\u03b8\u03b5\u03c1\u03b1\u03c0\u03b5\u03af\u03b1<\/h2>\n\n\n\n<p>\u0397 <strong>\u03b1\u03c0\u03bf\u03ba\u03b1\u03c4\u03ac\u03c3\u03c4\u03b1\u03c3\u03b7<\/strong> \u03bc\u03b5\u03c4\u03ac \u03b1\u03c0\u03cc \u03b1\u03bd\u03ac\u03c3\u03c4\u03c1\u03bf\u03c6\u03b7 \u03bf\u03bb\u03b9\u03ba\u03ae \u03b1\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae \u03ce\u03bc\u03bf\u03c5 \u03c0\u03b5\u03c1\u03b9\u03bb\u03b1\u03bc\u03b2\u03ac\u03bd\u03b5\u03b9 <strong>physiotherapy<\/strong>, \u03cc\u03c0\u03c9\u03c2 \u03bc\u03b5\u03c4\u03ac \u03b1\u03c0\u03cc \u03ba\u03ac\u03b8\u03b5 \u03c7\u03b5\u03b9\u03c1\u03bf\u03c5\u03c1\u03b3\u03b5\u03af\u03bf. \u03a3\u03c5\u03bd\u03ae\u03b8\u03c9\u03c2 \u03bf \u03b1\u03c3\u03b8\u03b5\u03bd\u03ae\u03c2 \u03b8\u03b1 \u03c6\u03cd\u03b3\u03b5\u03b9 \u03b1\u03c0\u03cc \u03c4\u03bf \u03bd\u03bf\u03c3\u03bf\u03ba\u03bf\u03bc\u03b5\u03af\u03bf \u03b3\u03b9\u03b1 \u03c4\u03bf \u03c3\u03c0\u03af\u03c4\u03b9 \u03bc\u03b5 \u03bc\u03af\u03b1 \u03b1\u03bd\u03ac\u03c1\u03c4\u03b7\u03c3\u03b7, \u03b1\u03bb\u03bb\u03ac \u03ba\u03b1\u03c4\u03ac \u03ba\u03b1\u03bd\u03cc\u03bd\u03b1 \u03bc\u03c0\u03bf\u03c1\u03b5\u03af \u03bd\u03b1 \u03ba\u03ac\u03bd\u03b5\u03b9 \u03c3\u03c7\u03b5\u03c4\u03b9\u03ba\u03ac \u03ac\u03bc\u03b5\u03c3\u03b1 \u03b5\u03ba\u03ba\u03c1\u03b5\u03bc\u03bf\u03b5\u03b9\u03b4\u03b5\u03af\u03c2 \u03ba\u03b9\u03bd\u03ae\u03c3\u03b5\u03b9\u03c2 \u03ba\u03b1\u03b9 \u03b1\u03c3\u03ba\u03ae\u03c3\u03b5\u03b9\u03c2 \u03b1\u03bd\u03cd\u03c8\u03c9\u03c3\u03b7\u03c2 \u03c3\u03c4\u03b1 \u03cc\u03c1\u03b9\u03b1 \u03c4\u03bf\u03c5 \u03c0\u03cc\u03bd\u03bf\u03c5. \u0397 \u03ba\u03b9\u03bd\u03b7\u03c4\u03bf\u03c0\u03bf\u03af\u03b7\u03c3\u03b7 \u03b5\u03af\u03bd\u03b1\u03b9 \u03c3\u03b1\u03c6\u03ce\u03c2 \u03c0\u03b9\u03bf \u03b3\u03c1\u03ae\u03b3\u03bf\u03c1\u03b7 \u03b1\u03c0\u03cc \u03c4\u03b7\u03bd \u03b1\u03c1\u03b8\u03c1\u03bf\u03c3\u03ba\u03bf\u03c0\u03b9\u03ba\u03ac \u03c3\u03c5\u03c1\u03c1\u03b1\u03c6\u03ae \u03c4\u03bf\u03c5 \u03c4\u03c1\u03bf\u03c6\u03b9\u03ba\u03bf\u03cd \u03c0\u03b5\u03c4\u03ac\u03bb\u03bf\u03c5, \u03ae \u03c4\u03b7\u03bd \u03b1\u03c1\u03b8\u03c1\u03bf\u03c3\u03ba\u03bf\u03c0\u03b9\u03ba\u03ac \u03c3\u03c4\u03b1\u03b8\u03b5\u03c1\u03bf\u03c0\u03bf\u03af\u03b7\u03c3\u03b7, \u03ba\u03b1\u03b8\u03ce\u03c2 \u03b4\u03b5\u03bd \u03b1\u03c0\u03b1\u03b9\u03c4\u03b5\u03af\u03c4\u03b1\u03b9 \u03b7 \u03b5\u03c0\u03bf\u03cd\u03bb\u03c9\u03c3\u03b7 \u03ba\u03ac\u03c0\u03bf\u03b9\u03bf\u03c5 \u03c4\u03ad\u03bd\u03bf\u03bd\u03c4\u03b1 \u03c3\u03c4\u03bf \u03bf\u03c3\u03c4\u03cc. <\/p>\n\n\n\n<p>\u0397 \u03b3\u03c1\u03b7\u03b3\u03bf\u03c1\u03cc\u03c4\u03b5\u03c1\u03b7 \u03b1\u03c0\u03bf\u03ba\u03b1\u03c4\u03ac\u03c3\u03c4\u03b1\u03c3\u03b7 \u03b1\u03c0\u03bf\u03c4\u03b5\u03bb\u03b5\u03af \u03bc\u03b5\u03b3\u03ac\u03bb\u03bf \u03c0\u03bb\u03b5\u03bf\u03bd\u03ad\u03ba\u03c4\u03b7\u03bc\u03b1, \u03b5\u03b9\u03b4\u03b9\u03ba\u03ac \u03c3\u03b5 \u03b1\u03c3\u03b8\u03b5\u03bd\u03b5\u03af\u03c2 \u03bc\u03b5\u03b3\u03b1\u03bb\u03cd\u03c4\u03b5\u03c1\u03bf\u03c5\u03c2 \u03c3\u03b5 \u03b7\u03bb\u03b9\u03ba\u03af\u03b1, \u03c0\u03bf\u03c5 \u03b8\u03b1 \u03c4\u03b1\u03bb\u03b1\u03b9\u03c0\u03c9\u03c1\u03bf\u03cd\u03bd\u03c4\u03b1\u03bd \u03b1\u03c0\u03cc \u03bc\u03b9\u03b1 \u03c0\u03b1\u03c1\u03b1\u03c4\u03b5\u03c4\u03b1\u03bc\u03ad\u03bd\u03b7 \u03b1\u03bd\u03ac\u03c1\u03c1\u03c9\u03c3\u03b7. <\/p>\n\n\n\n<p><\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"\u03b1\u03bd\u03b1\u03b8\u03b5\u03ce\u03c1\u03b7\u03c3\u03b7-\u03b1\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae\u03c2-\u03ce\u03bc\u03bf\u03c5-\u03c0\u03bf\u03b9\u03b5\u03c2-\u03b5\u03af\u03bd\u03b1\u03b9-\u03bf\u03b9-\u03b1\u03b9\u03c4\u03af\u03b5\u03c2\">Revision shoulder arthroplasty | Causes<\/h2>\n\n\n\n<p class=\"translation-block\">A shoulder operation has <strong>failed<\/strong> when the results do not meet the expectations of the patient and the surgeon. Failure can result from a number of causes, including stiffness, weakness, instability, pain, or failure to heal, as well as complications, such as periprosthetic infection or nerve injury. Every surgery comes with a risk of failure or post-operative complications, whether it is for a shoulder dislocation, rotator cuff tear, arthritis or fracture.<\/p>\n\n\n\n<div class=\"wp-block-uagb-container uagb-block-e1c252cc alignwide uagb-is-root-container\">\n<div class=\"wp-block-uagb-container uagb-block-20f59cfb\">\n<div class=\"wp-block-uagb-image uagb-block-c0e947e1 wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-none\"><figure class=\"wp-block-uagb-image__figure\"><img loading=\"lazy\" decoding=\"async\" srcset=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Revision-TSA1.jpg ,https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Revision-TSA1.jpg 780w, https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Revision-TSA1.jpg 360w\" sizes=\"auto, (max-width: 480px) 150px\" src=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Revision-TSA1.jpg\" alt=\"\u0391\u03bd\u03b1\u03c4\u03bf\u03bc\u03b9\u03ba\u03ae \u03b1\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae \u03bc\u03b5 \u03b1\u03bd\u03b5\u03c0\u03ac\u03c1\u03ba\u03b5\u03b9\u03b1 \u03c3\u03c4\u03c1\u03bf\u03c6\u03b9\u03ba\u03bf\u03cd \u03c0\u03b5\u03c4\u03ac\u03bb\u03bf\u03c5\" class=\"uag-image-5124\" width=\"1230\" height=\"1116\" title=\"Revision-TSA1\" role=\"img\"\/><figcaption class=\"uagb-image-caption\">TSA with cuff insufficiency<\/figcaption><\/figure><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-uagb-container uagb-block-f608bd45\">\n<div class=\"wp-block-uagb-image uagb-block-68d25ae9 wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-none\"><figure class=\"wp-block-uagb-image__figure\"><img loading=\"lazy\" decoding=\"async\" srcset=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Revision-TSA2.jpg ,https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Revision-TSA2.jpg 780w, https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Revision-TSA2.jpg 360w\" sizes=\"auto, (max-width: 480px) 150px\" src=\"https:\/\/drgpanagopoulos.com\/wp-content\/uploads\/Revision-TSA2.jpg\" alt=\"\u0391\u03bd\u03b1\u03b8\u03b5\u03ce\u03c1\u03b7\u03c3\u03b7 \u03c3\u03b5 \u03b1\u03bd\u03ac\u03c3\u03c4\u03c1\u03bf\u03c6\u03b7\" class=\"uag-image-5125\" width=\"714\" height=\"840\" title=\"Revision-TSA2\" role=\"img\"\/><figcaption class=\"uagb-image-caption\">Revision rTSA<\/figcaption><\/figure><\/div>\n<\/div>\n<\/div>\n\n\n\n<p class=\"translation-block\">When a shoulder surgery fails or presents with problems, the patient should consult with a <strong>experienced surgeon<\/strong> in the evaluation and management of these conditions. Although pain may seem to be the main problem, it is important to determine the possible mechanical causes of the patient issues, since a mechanical cause can be repaired and reversed.<\/p>\n\n\n\n<p class=\"translation-block\">Before making the final decision to surgically revise a shoulder arthroplasty, it is important to determine the nature of the patient's problems. Common causes of shoulder arthroplasty failure include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Periprothetic infection<\/strong><\/li>\n\n\n\n<li><strong>Periprothetic fractures<\/strong><\/li>\n\n\n\n<li class=\"translation-block\"><strong>Adverse reaction<\/strong> to polyethylene or cement (PMMA, polymethylmethacrylate)<\/li>\n\n\n\n<li><strong>Stiffness<\/strong>\n<ul class=\"wp-block-list\">\n<li>Bad rehabilitation<\/li>\n\n\n\n<li>Extra bone - osteophytes not removed, inadequate soft tissue release<\/li>\n\n\n\n<li>Tuberosity malunion<\/li>\n\n\n\n<li>Joint overstuffing<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Instability<\/strong>\n<ul class=\"wp-block-list\">\n<li>Anterior instability\n<ul class=\"wp-block-list\">\n<li>subscapularis deficiency&nbsp;<\/li>\n\n\n\n<li>too much glenoid anteversion<\/li>\n\n\n\n<li>tuberosity malunion<\/li>\n\n\n\n<li>supra\/infraspinatus deficiency&nbsp;<\/li>\n\n\n\n<li>problem in humeral anteversion or offset<\/li>\n\n\n\n<li>glenoid bone defect<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Posterior instability\n<ul class=\"wp-block-list\">\n<li>glenoid retroversion<\/li>\n\n\n\n<li>posterior cuff deficiency<\/li>\n\n\n\n<li>problem in humeral retroversion or offset<\/li>\n\n\n\n<li>glenoid bone defect<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Superior instability\n<ul class=\"wp-block-list\">\n<li>cuff deficiency<\/li>\n\n\n\n<li>coracoacromial arch<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Nerve injury<\/strong><\/li>\n\n\n\n<li><strong>Humeral implact<\/strong>\n<ul class=\"wp-block-list\">\n<li>malposition<\/li>\n\n\n\n<li>loosening<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Glenoid<\/strong>\n<ul class=\"wp-block-list\">\n<li>bone erosion (hemiarthroplasty)<\/li>\n\n\n\n<li>malposition<\/li>\n\n\n\n<li>loosening<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p class=\"translation-block\"><strong>Reverse arthroplasty<\/strong> provides a solution to the most common problems that an anatomical arthroplasty or a hemiarthroplasty can bring about over time, such as the gradual erosion of the glenoid (<strong>glenoid wear<\/strong>), or the secondary <strong>rotator cuff deficiency<\/strong>, which are also the most frequent reasons for revision. Also, rTSA is the treatment of choice in cases of failure of <strong>previous surgery<\/strong>, such as arthroscopy for tendon suturing, or failure of fixation of a humeral head fracture.<\/p>\n\n\n\n<p class=\"translation-block\"><strong>Shoulder arthroplasty infection<\/strong> is a difficult case, often requiring a 1- or 2-stage revision. The first stage usually involves removal of the previous prostheses and placement of a cement spacer, often impregnated with appropriate antibiotics. This is followed by targeted antibiotic therapy for 6 weeks, based on samples sent to the laboratory for culture. Finally, the second stage involves placing a new prosthesis.<\/p>\n\n\n\n<p class=\"translation-block\"><strong>Revision Shoulder Arthroplasty<\/strong> is a very demanding surgery and requires an Orthopedic Surgeon with extensive experience in similar cases. It also requires appropriate preparation and study, with careful preoperative planning, imaging, laboratory testing, and many times the participation of a wider therapeutic team, which may, in addition to the shoulder surgeon, include a musculoskeletal and interventional radiologist, an infectious disease specialist, a pathologist, and other specialties, depending on the needs of the patient (MDT, or multidisciplinary team).<\/p>\n\n\n\n<p class=\"translation-block\"><strong><a href=\"https:\/\/drgpanagopoulos.com\/en\/orthopaidikos-xeirourgos\/\" data-type=\"page\" data-id=\"5\" target=\"_self\">Dr Panagopoulos<\/a><\/strong> has extensive experience in revision shoulder arthroplasty, having served as an active member in a revision surgical center abroad. This operation must only be performed by a specialized Orthopedic Surgeon with relevant experience, with an organized surgical and medical team, in a specialized hospital with the necessary logistical infrastructure and workforce. <strong><a href=\"https:\/\/drgpanagopoulos.com\/en\/epikoinonia\/\" data-type=\"page\" data-id=\"584\" target=\"_self\">Contact us<\/a><\/strong> today to learn more about revision and reverse arthroplasty.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"faq-\u03c3\u03c5\u03c7\u03bd\u03ad\u03c2-\u03b5\u03c1\u03c9\u03c4\u03ae\u03c3\u03b5\u03b9\u03c2\">FAQs - Frequently Asked Questions<\/h2>\n\n\n<div id=\"rank-math-faq\" class=\"rank-math-block\">\n<div class=\"rank-math-list\">\n<div id=\"faq-question-1710260413086\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question\">What are the indications for reverse shoulder arthroplasty? <\/h3>\n<div class=\"rank-math-answer\">\n\n<p class=\"translation-block\">\u2013 Shoulder arthritis<br>\u2013 Massive rotator cuff tears<br>\u2013 Proximal humerus fractures<br>\u2013 Avascular necrosis (AVN)<br>\u2013 Malunion\/nonunion<br>\u2013 Failed RCR or ORIF<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-1710260518425\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question\">When do I need revision shoulder arthroplasty?<\/h3>\n<div class=\"rank-math-answer\">\n\n<p class=\"translation-block\">\u2013 Periprothetic infection<br>\u2013 Periprothetic fracture<br>\u2013 Prior failed arthroplasty<\/p>\n\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n\n<div class=\"wp-block-uagb-container uagb-block-f0c78fbe default uagb-is-root-container\">\n<div class=\"wp-block-uagb-container uagb-block-77c46601\">\n<div class=\"wp-block-uagb-info-box uagb-block-2fdac840 uagb-infobox__content-wrap  uagb-infobox-icon-above-title uagb-infobox-image-valign-top\"><div class=\"uagb-ifb-content\"><div class=\"uagb-ifb-icon-wrap\"><svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewbox=\"0 0 384 512\"><path d=\"M168.3 499.2C116.1 435 0 279.4 0 192C0 85.96 85.96 0 192 0C298 0 384 85.96 384 192C384 279.4 267 435 215.7 499.2C203.4 514.5 180.6 514.5 168.3 499.2H168.3zM192 256C227.3 256 256 227.3 256 192C256 156.7 227.3 128 192 128C156.7 128 128 156.7 128 192C128 227.3 156.7 256 192 256z\"><\/path><\/svg><\/div><div class=\"uagb-ifb-title-wrap\"><h4 class=\"uagb-ifb-title\">Athens<\/h4><\/div><p class=\"uagb-ifb-desc\"><a href=\"https:\/\/maps.app.goo.gl\/BEmxqgDN1X6dZg5c8\" target=\"_blank\" rel=\"noreferrer noopener\">Solonos 31, Kolonaki 106 71<\/a><\/p><\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-uagb-container uagb-block-57cd5a88\">\n<div class=\"wp-block-uagb-info-box uagb-block-49841691 uagb-infobox__content-wrap  uagb-infobox-icon-above-title uagb-infobox-image-valign-top\"><div class=\"uagb-ifb-content\"><div class=\"uagb-ifb-icon-wrap\"><svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewbox=\"0 0 448 512\"><path d=\"M285.6 444.1C279.8 458.3 264.8 466.3 249.8 463.4C234.8 460.4 223.1 447.3 223.1 432V256H47.1C32.71 256 19.55 245.2 16.6 230.2C13.65 215.2 21.73 200.2 35.88 194.4L387.9 50.38C399.8 45.5 413.5 48.26 422.6 57.37C431.7 66.49 434.5 80.19 429.6 92.12L285.6 444.1z\"><\/path><\/svg><\/div><div class=\"uagb-ifb-title-wrap\"><h4 class=\"uagb-ifb-title\">Marousi<\/h4><\/div><p class=\"uagb-ifb-desc\"><a href=\"https:\/\/goo.gl\/maps\/pEhC2FhtNRm1PczT8\" target=\"_blank\" rel=\"noreferrer noopener\">Kifisias 58 Ave, 151 25<\/a><\/p><\/div><\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-uagb-container uagb-block-5aebfae2 default uagb-is-root-container\">\n<div class=\"wp-block-uagb-container uagb-block-32057e61\">\n<div class=\"wp-block-uagb-info-box uagb-block-e662ea13 uagb-infobox__content-wrap  uagb-infobox-icon-above-title uagb-infobox-image-valign-top\"><div class=\"uagb-ifb-content\"><div class=\"uagb-ifb-icon-wrap\"><svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewbox=\"0 0 512 512\"><path d=\"M511.2 387l-23.25 100.8c-3.266 14.25-15.79 24.22-30.46 24.22C205.2 512 0 306.8 0 54.5c0-14.66 9.969-27.2 24.22-30.45l100.8-23.25C139.7-2.602 154.7 5.018 160.8 18.92l46.52 108.5c5.438 12.78 1.77 27.67-8.98 36.45L144.5 207.1c33.98 69.22 90.26 125.5 159.5 159.5l44.08-53.8c8.688-10.78 23.69-14.51 36.47-8.975l108.5 46.51C506.1 357.2 514.6 372.4 511.2 387z\"><\/path><\/svg><\/div><div class=\"uagb-ifb-title-wrap\"><h4 class=\"uagb-ifb-title\">Mobile<\/h4><\/div><p class=\"uagb-ifb-desc\"><a href=\"tel:2103639885\" target=\"_blank\" rel=\"noreferrer noopener\">+30 210 3639885<\/a><\/p><\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-uagb-container uagb-block-953cad24\">\n<div class=\"wp-block-uagb-info-box uagb-block-30f6ae74 uagb-infobox__content-wrap  uagb-infobox-icon-above-title uagb-infobox-image-valign-top\"><div class=\"uagb-ifb-content\"><div class=\"uagb-ifb-icon-wrap\"><svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewbox=\"0 0 384 512\"><path d=\"M320 0H64C37.49 0 16 21.49 16 48v416C16 490.5 37.49 512 64 512h256c26.51 0 48-21.49 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\u03b5\u03c0\u03b9\u03c4\u03c5\u03c7\u03b7\u03bc\u03ad\u03bd\u03b7 \u03b5\u03c0\u03ad\u03bc\u03b2\u03b1\u03c3\u03b7 \u03c0\u03bf\u03c5 \u03ad\u03c7\u03b5\u03b9 \u03b3\u03af\u03bd\u03b5\u03b9 \u03b5\u03be\u03b1\u03b9\u03c1\u03b5\u03c4\u03b9\u03ba\u03ac \u03b4\u03b7\u03bc\u03bf\u03c6\u03b9\u03bb\u03ae\u03c2 \u03c0\u03b1\u03b3\u03ba\u03bf\u03c3\u03bc\u03af\u03c9\u03c2 \u03c4\u03b1 \u03c4\u03b5\u03bb\u03b5\u03c5\u03c4\u03b1\u03af\u03b1 \u03c7\u03c1\u03cc\u03bd\u03b9\u03b1, \u03bc\u03b5 \u03c4\u03b1 \u03b1\u03c0\u03bf\u03c4\u03b5\u03bb\u03ad\u03c3\u03bc\u03b1\u03c4\u03b1 \u03bd\u03b1 \u03b5\u03af\u03bd\u03b1\u03b9 \u03c0\u03bf\u03bb\u03cd \u03b5\u03bd\u03b8\u03b1\u03c1\u03c1\u03c5\u03bd\u03c4\u03b9\u03ba\u03ac. \u03a3\u03c4\u03b7\u03bd&nbsp;\u03b1\u03bd\u03ac\u03c3\u03c4\u03c1\u03bf\u03c6\u03b7 \u03b1\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae,&nbsp;\u03b7 \u03b1\u03bd\u03c4\u03b9\u03ba\u03b1\u03c4\u03ac\u03c3\u03c4\u03b1\u03c3\u03b7 \u03c4\u03c9\u03bd \u03c6\u03b8\u03b1\u03c1\u03bc\u03ad\u03bd\u03c9\u03bd \u03b5\u03c0\u03b9\u03c6\u03b1\u03bd\u03b5\u03b9\u03ce\u03bd&nbsp;\u03b1\u03bd\u03c4\u03b9\u03c3\u03c4\u03c1\u03ad\u03c6\u03b5\u03c4\u03b1\u03b9&nbsp;\u03c3\u03b5 \u03c3\u03c7\u03ad\u03c3\u03b7 \u03bc\u03b5 \u03c4\u03b7\u03bd \u03c6\u03c5\u03c3\u03b9\u03bf\u03bb\u03bf\u03b3\u03b9\u03ba\u03ae \u03b1\u03bd\u03b1\u03c4\u03bf\u03bc\u03af\u03b1 \u03c4\u03bf\u03c5 \u03ce\u03bc\u03bf\u03c5 \u03ba\u03b1\u03b9 \u03c4\u03b7\u03bd \u03b1\u03bd\u03b1\u03c4\u03bf\u03bc\u03b9\u03ba\u03ae \u03b1\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae. \u039f\u03b9 \u03b5\u03bd\u03b4\u03b5\u03af\u03be\u03b5\u03b9\u03c2 \u03b3\u03b9\u03b1 \u03c4\u03b7\u03bd \u03b5\u03c0\u03ad\u03bc\u03b2\u03b1\u03c3\u03b7 \u03b1\u03c5\u03c4\u03ae \u03ad\u03c7\u03bf\u03c5\u03bd \u03b5\u03c0\u03b5\u03ba\u03c4\u03b1\u03b8\u03b5\u03af \u03b4\u03c1\u03b1\u03bc\u03b1\u03c4\u03b9\u03ba\u03ac \u03c4\u03b1 \u03c4\u03b5\u03bb\u03b5\u03c5\u03c4\u03b1\u03af\u03b1 \u03c7\u03c1\u03cc\u03bd\u03b9\u03b1, \u03bc\u03b5 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":5098,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_eb_attr":"","_uag_custom_page_level_css":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"disabled","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center 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Panagopoulos","author_link":"https:\/\/drgpanagopoulos.com\/en\/author\/gnpanagopoulosgmail-com\/"},"uagb_comment_info":1,"uagb_excerpt":"\u0397 \u03b1\u03bd\u03ac\u03c3\u03c4\u03c1\u03bf\u03c6\u03b7 \u03b1\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae \u03ce\u03bc\u03bf\u03c5 \u03b5\u03af\u03bd\u03b1\u03b9 \u03bc\u03b9\u03b1 \u03c0\u03bf\u03bb\u03cd \u03b5\u03c0\u03b9\u03c4\u03c5\u03c7\u03b7\u03bc\u03ad\u03bd\u03b7 \u03b5\u03c0\u03ad\u03bc\u03b2\u03b1\u03c3\u03b7 \u03c0\u03bf\u03c5 \u03ad\u03c7\u03b5\u03b9 \u03b3\u03af\u03bd\u03b5\u03b9 \u03b5\u03be\u03b1\u03b9\u03c1\u03b5\u03c4\u03b9\u03ba\u03ac \u03b4\u03b7\u03bc\u03bf\u03c6\u03b9\u03bb\u03ae\u03c2 \u03c0\u03b1\u03b3\u03ba\u03bf\u03c3\u03bc\u03af\u03c9\u03c2 \u03c4\u03b1 \u03c4\u03b5\u03bb\u03b5\u03c5\u03c4\u03b1\u03af\u03b1 \u03c7\u03c1\u03cc\u03bd\u03b9\u03b1, \u03bc\u03b5 \u03c4\u03b1 \u03b1\u03c0\u03bf\u03c4\u03b5\u03bb\u03ad\u03c3\u03bc\u03b1\u03c4\u03b1 \u03bd\u03b1 \u03b5\u03af\u03bd\u03b1\u03b9 \u03c0\u03bf\u03bb\u03cd \u03b5\u03bd\u03b8\u03b1\u03c1\u03c1\u03c5\u03bd\u03c4\u03b9\u03ba\u03ac. \u03a3\u03c4\u03b7\u03bd&nbsp;\u03b1\u03bd\u03ac\u03c3\u03c4\u03c1\u03bf\u03c6\u03b7 \u03b1\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae,&nbsp;\u03b7 \u03b1\u03bd\u03c4\u03b9\u03ba\u03b1\u03c4\u03ac\u03c3\u03c4\u03b1\u03c3\u03b7 \u03c4\u03c9\u03bd \u03c6\u03b8\u03b1\u03c1\u03bc\u03ad\u03bd\u03c9\u03bd \u03b5\u03c0\u03b9\u03c6\u03b1\u03bd\u03b5\u03b9\u03ce\u03bd&nbsp;\u03b1\u03bd\u03c4\u03b9\u03c3\u03c4\u03c1\u03ad\u03c6\u03b5\u03c4\u03b1\u03b9&nbsp;\u03c3\u03b5 \u03c3\u03c7\u03ad\u03c3\u03b7 \u03bc\u03b5 \u03c4\u03b7\u03bd \u03c6\u03c5\u03c3\u03b9\u03bf\u03bb\u03bf\u03b3\u03b9\u03ba\u03ae \u03b1\u03bd\u03b1\u03c4\u03bf\u03bc\u03af\u03b1 \u03c4\u03bf\u03c5 \u03ce\u03bc\u03bf\u03c5 \u03ba\u03b1\u03b9 \u03c4\u03b7\u03bd \u03b1\u03bd\u03b1\u03c4\u03bf\u03bc\u03b9\u03ba\u03ae \u03b1\u03c1\u03b8\u03c1\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ae. \u039f\u03b9 \u03b5\u03bd\u03b4\u03b5\u03af\u03be\u03b5\u03b9\u03c2 \u03b3\u03b9\u03b1 \u03c4\u03b7\u03bd \u03b5\u03c0\u03ad\u03bc\u03b2\u03b1\u03c3\u03b7 \u03b1\u03c5\u03c4\u03ae \u03ad\u03c7\u03bf\u03c5\u03bd \u03b5\u03c0\u03b5\u03ba\u03c4\u03b1\u03b8\u03b5\u03af \u03b4\u03c1\u03b1\u03bc\u03b1\u03c4\u03b9\u03ba\u03ac \u03c4\u03b1 \u03c4\u03b5\u03bb\u03b5\u03c5\u03c4\u03b1\u03af\u03b1 \u03c7\u03c1\u03cc\u03bd\u03b9\u03b1, \u03bc\u03b5&hellip;","_links":{"self":[{"href":"https:\/\/drgpanagopoulos.com\/en\/wp-json\/wp\/v2\/posts\/5097","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drgpanagopoulos.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drgpanagopoulos.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drgpanagopoulos.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/drgpanagopoulos.com\/en\/wp-json\/wp\/v2\/comments?post=5097"}],"version-history":[{"count":13,"href":"https:\/\/drgpanagopoulos.com\/en\/wp-json\/wp\/v2\/posts\/5097\/revisions"}],"predecessor-version":[{"id":5971,"href":"https:\/\/drgpanagopoulos.com\/en\/wp-json\/wp\/v2\/posts\/5097\/revisions\/5971"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drgpanagopoulos.com\/en\/wp-json\/wp\/v2\/media\/5098"}],"wp:attachment":[{"href":"https:\/\/drgpanagopoulos.com\/en\/wp-json\/wp\/v2\/media?parent=5097"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drgpanagopoulos.com\/en\/wp-json\/wp\/v2\/categories?post=5097"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drgpanagopoulos.com\/en\/wp-json\/wp\/v2\/tags?post=5097"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}