Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Shoulder 158 articles


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.

Nerve Monitoring During Proximal Humeral Fracture Fixation: What Have We Learned?

William J. Warrender BS, Stephen Oppenheimer MD, PhD, Joseph A. Abboud MD

The incidence of neurologic injury after proximal humerus fractures is variable, ranging from 6.2% to as much as 67%. However, it is unclear what factors might contribute to these injuries or whether they can be prevented by intraoperative nerve monitoring.

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.

Emerging Ideas: Evaluation of Stem Cells Genetically Modified with Scleraxis to Improve Rotator Cuff Healing

Lawrence V. Gulotta MD, Scott A. Rodeo MD

Rotator cuffs heal with an interposed layer of scar tissue that makes repairs prone to failure. Cell-based biologic therapies have the potential to augment this healing process. Scleraxis (Scx) is a transcription factor that is involved in tendon development during embryogenesis, and may help drive stem cells toward tenocyte differentiation in adults.

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.