Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Symposium: Reverse Total Shoulder Arthroplasty 23 articles

Articles

A Radiographic Classification of Massive Rotator Cuff Tear Arthritis

Kazutoshi Hamada MD, PhD, Kaoru Yamanaka MD, PhD, Yoshiyasu Uchiyama MD, PhD, Takahiko Mikasa MD, Motohiko Mikasa MD, PhD

In 1990, Hamada et al. radiographically classified massive rotator cuff tears into five grades. Walch et al. subsequently subdivided Grade 4 to reflect the presence/absence of subacromial arthritis and emphasize glenohumeral arthritis as a characteristic of Grade 4.

How Reverse Shoulder Arthroplasty Works

Matthew Walker MD, Jordan Brooks BS, Matthew Willis MD, Mark Frankle MD

The reverse total shoulder arthroplasty was introduced to treat the rotator cuff-deficient shoulder. Since its introduction, an improved understanding of the biomechanics of rotator cuff deficiency and reverse shoulder arthroplasty has facilitated the development of modern reverse arthroplasty designs.

Scapula Fractures After Reverse Total Shoulder Arthroplasty: Classification and Treatment

Lynn A. Crosby MD, Adam Hamilton MD, Todd Twiss MD

Reverse total shoulder arthroplasty (RTSA) implants have been developed to treat patients with deficient rotator cuffs. The nature of this procedure’s complications and how these complications should be managed continues to evolve. Fractures of the scapula after RTSA have been described, but the incidence and best methods of treatment are unclear.

Surgical Technique: The Anterosuperior Approach for Reverse Shoulder Arthroplasty

Daniel Molé MD, Frank Wein MD, Charles Dézaly MD, Philippe Valenti MD, François Sirveaux MD

The anterosuperior approach used for reverse shoulder arthroplasty is an intermediate between the transacromial approach originally proposed by Paul Grammont and the anterosuperior approach described by D. B. Mackenzie for shoulder arthroplasty. As an alternative to the deltopectoral approach, the anterosuperior approach has the advantages of simplicity and postoperative stability.

Do Less Medialized Reverse Shoulder Prostheses Increase Motion and Reduce Notching?

Philippe Valenti MD, Philippe Sauzières MD, Denis Katz MD, Ibrahim Kalouche MD, Alexandre Sahin Kilinc MD

Cuff tear arthropathy is the primary indication for total reverse shoulder arthroplasty. In patients with pseudoparalytic shoulders secondary to irreparable rotator cuff tear, reverse shoulder arthroplasty allows restoration of active anterior elevation and painless shoulder. High rates of glenoid notching have also been reported. We designed a new reverse shoulder arthroplasty with a center of rotation more lateral than the Delta prosthesis to address this problem.

Reverse Prostheses in Arthropathies With Cuff Tear: Are Survivorship and Function Maintained Over Time?

Luc Favard MD, Christophe Levigne MD, Cécile Nerot MD, Christian Gerber MD, Lieven Wilde MD, Daniel Mole MD

The use of reverse shoulder arthroplasty has considerably increased since first introduced in 1985. Despite demonstrating early improvement of function and pain, there is limited information regarding the durability and longer-term outcomes of this prosthesis.

A Complication-based Learning Curve From 200 Reverse Shoulder Arthroplasties

Laurence B. Kempton MD, Elizabeth Ankerson BS, J. Michael Wiater MD

Reported early complication rates in reverse total shoulder arthroplasty have widely varied from 0% to 75% in part due to a lack of standard inclusion criteria. In addition, it is unclear whether revision arthroplasty is associated with a higher rate of complications than primary arthroplasty.

Bony Increased-offset Reversed Shoulder Arthroplasty: Minimizing Scapular Impingement While Maximizing Glenoid Fixation

Pascal Boileau MD, Grégory Moineau MD, Yannick Roussanne MD, Kieran O’Shea FRCSI

Scapular notching, prosthetic instability, limited shoulder rotation and loss of shoulder contour are associated with conventional medialized design reverse shoulder arthroplasty. Prosthetic (ie, metallic) lateralization increases torque at the baseplate-glenoid interface potentially leading to failure.

Two-stage Reimplantation for Treating Prosthetic Shoulder Infections

Vani J. Sabesan MD, Jason C. Ho MS, David Kovacevic MD, Joseph P. Iannotti MD, PhD

Two-stage reimplantation for prosthetic joint infection reportedly has the lowest risk for recurrent infection. Most studies to date have evaluated revision surgery for infection using an anatomic prosthetic. As compared with anatomic prostheses, reverse total shoulder arthroplasty is reported to have a higher rate of infection.

Does Reverse Shoulder Arthroplasty for Tumors of the Proximal Humerus Reduce Impairment?

Lieven Wilde MD, PhD, Pascal Boileau MD, PhD, Hans Bracht MD

Normal function of the upper limb is seldom restored after limb-sparing surgery for tumors of the proximal humerus. The literature suggests superior shoulder function is achieved in the short term with reverse total shoulder arthroplasty compared to other techniques when performed for conditions with rotator cuff deficiency. It is unclear whether this superiority is maintained when reverse total shoulder arthroplasty is performed for tumors.

Grammont’s Idea: The Story of Paul Grammont’s Functional Surgery Concept and the Development of the Reverse Principle

Emmanuel Baulot MD, François Sirveaux MD, Pascal Boileau MD

The increased use of the reverse prosthesis over the last 10 years is due to a large series of publications using the reverse prosthesis developed by Paul Grammont. However, there is no article reporting the story of the concepts developed by Grammont.

A History of Reverse Total Shoulder Arthroplasty

Evan L. Flatow MD, Alicia K. Harrison MD

Management of the cuff-deficient arthritic shoulder has long been challenging. Early unconstrained shoulder arthroplasty systems were associated with high complication and implant failure rates. The evolution toward the modern reverse shoulder arthroplasty includes many variables of constrained shoulder arthroplasty designs.

Scapular Notching: Recognition and Strategies to Minimize Clinical Impact

Gregory P. Nicholson MD, Eric J. Strauss MD, Seth L. Sherman MD

Scapular notching is a unique complication of Grammont-style reverse total shoulder arthroplasty. While reverse total shoulder arthroplasty has revolutionized the treatment of pseudoparalysis secondary to cuff tear arthropathy, the implications of scapular notching with regard to patient function and implant stability remain unclear.

Scapular Notching in Reverse Shoulder Arthroplasty: Is It Important to Avoid It and How?

Christophe Lévigne MD, Jérome Garret MD, Pascal Boileau MD, Ghassan Alami MD, Luc Favard MD, Gilles Walch MD

Scapular notching, erosion of the scapular neck related to impingement by the medial rim of the humeral cup during adduction, is a radiographic sign specific to reverse shoulder arthroplasty (RSA). Its clinical and radiological consequences remain unclear.

What Are the Instability and Infection Rates After Reverse Shoulder Arthroplasty?

George J. Trappey MD, Daniel P. O’Connor PhD, T. Bradley Edwards MD

A concern regarding reverse shoulder arthroplasty (RSA) is the possibly higher complication rate compared with conventional unconstrained shoulder arthroplasty.

Is Reverse Shoulder Arthroplasty a Reasonable Alternative for Revision Arthroplasty?

Luke Austin MD, Benjamin Zmistowski BS, Edward S. Chang MD, Gerald R. Williams MD

Reverse shoulder arthroplasty (RSA) improves function in selected patients with complex shoulder problems. However, we presume patient function would vary if performed primarily or for revision and would vary with other patient-specific factors.

Reverse Total Shoulder Arthroplasty Improves Function in Cuff Tear Arthropathy

Betsy M. Nolan MD, Elizabeth Ankerson BS, J. Michael Wiater MD

Early failure due to glenoid loosening with anatomic total shoulder arthroplasty in patients with severe rotator cuff deficiency led to the development of the reverse ball-and-socket shoulder prosthesis. The literature reports improved short-term pain and function scores following modern reverse total shoulder arthroplasty (RTSA) in patients with cuff tear arthropathy (CTA).

Can Reverse Shoulder Arthroplasty be Used with Few Complications in Rheumatoid Arthritis?

Anders Ekelund MD, PhD, Ragnhild Nyberg PT

Many patients with rheumatoid arthritis develop superior migration of the humeral head because of massive cuff tears, causing loss of active motion. Reverse shoulder arthroplasty could potentially restore biomechanical balance but a high incidence of glenoid failure has been reported. These studies do not, however, typically include many patients with rheumatoid arthritis (RA) and it is unclear whether the failure rates are similar.