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Review
. 2021 Mar 1;6(3):189-201.
doi: 10.1302/2058-5241.6.200085. eCollection 2021 Mar.

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

Thomas Kozak  1   2 , Stefan Bauer  3 , Gilles Walch  4 , Saad Al-Karawi  1 , William Blakeney  1   2
Affiliations
Review

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

Thomas Kozak et al. EFORT Open Rev. .

Abstract

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.

Keywords: acromion fracture; arthroplasty; design; indications; reverse; shoulder; subscapularis repair.

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Conflict of interest statement

ICMJE Conflict of interest statement: GW reports consulting fees, Support for travel to meetings for study or other purposes and royalties from Wright, related to the submitted work. The other authors declare no conflict of interest relevant to this work.

Figures

Fig. 1
Fig. 1
Traditional Grammont-style prosthesis with medialized glenoid and 155° neck-shaft angle and inlay humeral component. Eccentric glenosphere has been used to avoid notching.
Fig. 2
Fig. 2
Lateralized humeral component with 135° neck-shaft angle and onlay design. Lateralized glenoid component with metal augmentation (A) or bone augmentation (B).
Fig. 3
Fig. 3
Stemless design reverse total shoulder arthroplasty (RTSA) with periprosthetic fracture.
Fig. 4
Fig. 4
Radiograph of scapula spine fracture post reverse total shoulder arthroplasty (RTSA) (A). Three-dimensional surgical planning for plate fixation (B). Postoperative radiographs (C).
See this image and copyright information in PMC

References

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