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Updated: Jul 7, 2026
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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
A posterosuperior approach to the shoulder
1Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands. P.M.Rozing@lumc.nl
Journal of Shoulder and Elbow Surgery
|February 16, 2008
Summary
A novel posterosuperior surgical approach offers improved exposure for shoulder arthroplasty, enabling glenoid reorientation and rotator cuff repair. This technique provides a viable alternative to traditional incisions for specific patient cases.
Area of Science:
- Orthopedic Surgery
- Shoulder Reconstruction
- Surgical Techniques
Background:
- Traditional deltopectoral incisions may limit surgical access to the posterior glenoid and rotator cuff.
- Shoulder arthroplasty often requires precise glenoid component placement and can involve concurrent rotator cuff repair.
Purpose of the Study:
- To present a posterosuperior surgical approach as an alternative for enhanced visualization during shoulder arthroplasty.
- To evaluate the efficacy of this approach for glenoid reorientation, revision surgery, and rotator cuff repair.
Main Methods:
- The technique involves an osteotomy of the acromion's lateral rim and posterior corner with deltoid muscle reflection.
- A specialized plate facilitates stable fixation of the osteotomy.
- The approach was utilized in 79 patients for shoulder prosthesis insertion since 1994.
Main Results:
- In 72 patients undergoing shoulder arthroplasty, 24 had rotator cuff pathology, with 22 successfully repaired.
- Twenty-two patients benefited from glenoid reorientation, achieving an average superior tilt correction of 7 degrees.
- Osteotomy healing was successful in all but one patient; fixation material removal was needed in 13 cases.
Conclusions:
- The posterosuperior approach provides effective surgical exposure for shoulder arthroplasty, facilitating glenoid procedures and rotator cuff repair.
- While external rotator release is part of the technique, significant weakening was not observed post-operatively.
- This method represents a valuable alternative for selected cases requiring complex shoulder reconstruction.
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