scholarly journals An update on reverse total shoulder arthroplasty: current indications, new designs, same old problems

2021 ◽  
Vol 6 (3) ◽  
pp. 189-201
Author(s):  
Thomas Kozak ◽  
Stefan Bauer ◽  
Gilles Walch ◽  
Saad Al-karawi ◽  
William Blakeney
Keyword(s):  
Shoulder Arthroplasty ◽  
Mixed Reality ◽  
Total Shoulder Arthroplasty ◽  
Computer Navigation ◽  
Reverse Total Shoulder Arthroplasty ◽  
Patient Specific ◽  
Shoulder Replacement ◽  
Neck Shaft Angle ◽  
Shaft Angle ◽  
Reverse Total Shoulder

Reverse total shoulder arthroplasty (RTSA) was originally developed because of unsatisfactory results with anatomic shoulder arthroplasty options for the majority of degenerative shoulder conditions and fractures. After initial concerns about RTSA longevity, indications were extended to primary osteoarthritis with glenoid deficiency, massive cuff tears in younger patients, fracture, tumour and failed anatomic total shoulder replacement. Traditional RTSA by Grammont has undergone a number of iterations such as glenoid lateralization, reduced neck-shaft angle, modular, stemless components and onlay systems. The incidence of complications such as dislocation, notching and acromial fractures has also evolved. Computer navigation, 3D planning and patient-specific implantation have been in use for several years and mixed-reality guided implantation is currently being trialled. Controversies in RTSA include lateralization, stemless humeral components, subscapularis repair and treatment of acromial fractures. Cite this article: EFORT Open Rev 2021;6:189-201. DOI: 10.1302/2058-5241.6.200085

Biomechanical effects of humeral neck-shaft angle and subscapularis integrity in reverse total shoulder arthroplasty

2014 ◽  
Vol 23 (8) ◽  
pp. 1091-1098 ◽  
Author(s):  
Joo Han Oh ◽  
Sang-Jin Shin ◽  
Michelle H. McGarry ◽  
Jonathan H. Scott ◽  
Nathanael Heckmann ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Neck Shaft Angle ◽  
Shaft Angle ◽  
Reverse Total Shoulder

Biomechanical Differences in Reverse Total Shoulder Arthroplasty According to the Humeral Neck-Shaft Angle

2013 ◽  
Vol 22 (4) ◽  
pp. e37-e38 ◽  
Author(s):  
Joo Han Oh ◽  
Sang Jin Sin ◽  
Seok Won Chung ◽  
Michelle H. McGarry ◽  
Jonathan Scott ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Neck Shaft Angle ◽  
Shaft Angle ◽  
Reverse Total Shoulder

Preoperative three-dimensional computer planning for reverse total shoulder arthroplasty and bone grafting for severe glenoid deformity

2020 ◽  
pp. 175857322090890
Author(s):  
Robert Z Tashjian ◽  
Lindsay Beck ◽  
Irene Stertz ◽  
Peter N Chalmers
Keyword(s):  
Shoulder Arthroplasty ◽  
Bone Grafting ◽  
Total Shoulder Arthroplasty ◽  
Three Dimensional ◽  
Reverse Total Shoulder Arthroplasty ◽  
Patient Specific ◽  
Computer Assisted ◽  
Patient Specific Instrumentation ◽  
Reverse Total Shoulder ◽  
Glenoid Erosion

Background Computer assisted planning without patient specific instrumentation may be utilized to guide reverse total shoulder arthroplasty baseplate placement. The purpose of this study was to determine the difference between planned and achieved inclination and retroversion correction with three-dimensional preoperative computer assisted planning in reverse total shoulder arthroplasty without patient specific instrumentation with bone grafting for severe glenoid erosion. Methods Preoperative three-dimensional computer assisted planning without patient specific instrumentation was performed on 15 patients undergoing primary reverse total shoulder arthroplasty with glenoid bone grafting for severe glenoid erosion. On preoperative and immediate postoperative computed tomography slices, two-dimensional retroversion and inclination were measured. Preoperative three-dimensional baseline retroversion and inclination and planned postoperative three-dimensional retroversion and inclination were measured. Planned and achieved version and inclination changes were compared. Results The planned and achieved retroversion corrections were 18° and 12°, respectively (p < 0.001). The planned and achieved inclination corrections were 11° and 11°, respectively (p = 0.803). Conclusions Three-dimensional computer assisted planning without patient specific instrumentation in the setting of reverse total shoulder arthroplasty with severe glenoid erosion requiring bone grafting can accurately guide baseplate placement. All cases in which failure to correct retroversion or inclination within 10° of planning occurred in patients with severe erosion (B3 or E3 glenoids), therefore patient specific guides may be warranted in these cases to improve accuracy of implantation. Level of evidence Level IV, retrospective case series.

scholarly journals Anatomic shoulder arthroplasty: an update on indications, technique, results and complication rates

Joints ◽  
2015 ◽  
Vol 03 (02) ◽  
pp. 72-77 ◽  
Author(s):  
Lorenzo Mattei ◽  
Stefano Mortera ◽  
Chiara Arrigoni ◽  
Filippo Castoldi
Keyword(s):  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
Scientific Community ◽  
Total Shoulder Arthroplasty ◽  
Persistent Pain ◽  
Reverse Total Shoulder Arthroplasty ◽  
Complication Rates ◽  
Shoulder Replacement ◽  
Reverse Total Shoulder ◽  
Loss Of Strength

A shoulder replacement is indicated in patients affected by glenohumeral arthropathy with severely reduced range of motion, persistent pain, especially at night, and loss of strength. There is much discussion in the scientific community about the prosthetic options for these cases: hemiarthroplasty, anatomic total shoulder arthroplasty, and reverse total shoulder arthroplasty. We analyzed the indications for, results of, and complications associated with this kind of surgery, focusing on anatomic arthroplasty and on the concept of modularity.

Shoulder joint arthroplasty in young patients: Analysis of 8742 patients from the Australian Orthopaedic Association National Joint Replacement Registry

2021 ◽  
pp. 175857322110587
Author(s):  
Andrew Phillip McBride ◽  
Mark Ross ◽  
Phil Duke ◽  
Greg Hoy ◽  
Richard Page ◽  
...  
Keyword(s):  
Joint Replacement ◽  
Shoulder Arthroplasty ◽  
Revision Rate ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Age Group ◽  
Shoulder Replacement ◽  
Younger Patients ◽  
Joint Replacement Registry ◽  
Reverse Total Shoulder

Background Shoulder replacement is a reliable treatment for the relief of pain and improvement of function in patients with glenohumeral arthritis, rotator cuff arthropathy, osteonecrosis and fracture. Limited data is available comparing revision rates for the different types of shoulder replacement when used in younger patients. This study aims to compare the survivorship of hemi resurfacing, stemmed hemiarthroplasty, total shoulder arthroplasty and reverse total shoulder arthroplasty in younger patients using data from a large national arthroplasty registry. Methods Data from the Australian Orthopaedic Association National Joint Replacement Registry was obtained for the period 16 April 2004–31 December 2018. The study population included all shoulder arthroplasty patients aged <65 years. These were stratified into two groups: <55 years and 55–64 years. A total of 8742 primary shoulder arthroplasty procedures were analysed (1936 procedures in the <55 years and 6806 in the 55–64 years age group). Results In the <55 years age group, there was no difference in revision rate for total shoulder arthroplasty versus reverse total shoulder arthroplasty at any time point. Reverse total shoulder arthroplasty had a lower revision rate after six months when compared to hemi resurfacing (HRA) (p = 0.031). Also, reverse total shoulder arthroplasty had a higher early rate of revision in the first 12 months compared to hemiarthroplasty (p = 0.018). However, from 2 years reverse total shoulder arthroplasty had a lower revision rate overall (p = 0.029). In the 55–64 years patient age group, reverse total shoulder arthroplasty had a lower earlier revision rate. This was statistically significant compared to hemi resurfacing (HRA) (p = 0.028), hemiarthroplasty (p = 0.049) and total shoulder arthroplasty (p < 0.001). Conclusion This study demonstrated that for patients aged <55 years there was no significant difference in the rate of revision when total shoulder arthroplasty and reverse total shoulder arthroplasty were compared. reverse total shoulder arthroplasty had a lower rate of revision when compared to hemi resurfacing and hemiarthroplasty after 2 years. reverse total shoulder arthroplasty had the lowest comparative revision rate in patients aged 55–64 years overall.

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