KW - Reverse total shoulder arthroplasty
Scapular notching in reverse shoulder arthroplasty.
The treatment options for patients with this condition are very few. Non-constraint conventional shoulder replacement; either resurfacing or stemmed hemiarthroplasty would provide them with pain relieve but no improvement of active motion and in cases of antero-superior escape will fail to improve their stability. Bi-polar hemiarthroplasty will probably do the same. The only option to improve these patients range of motion is by using a semi-constrained prosthesis with reversed geometry design, which allows the deltoid muscle to function better and improve the shoulder mobility. All designs of reversed shoulder prosthesis in the 70s have failed due to their excessive lateralisation of centre of rotation causing increased toque on the implant-bone interface of the glenoid component leading to glenoid loosening. Professor Grammonts idea of medialisation of centre of rotation towards the face of the glenoid and tensioning the glenoid muscle inferiorly has shown to be successful.
Reverse Shoulder Prosthesis (RSP) | DJO Global
Reversed shoulder prostheses aregaining popularity in recent years. Good mid-term results with restoration of active elevation have been reported. However there is a high complication rate with a stemmed prostheses ranging between 24% to 50% in different series and many of them require further surgery.