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Updated: Jun 25, 2026
10:10
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Acromial insufficiency in reverse shoulder arthroplasties
Gilles Walch1, Franck Mottier, Bryan Wall
1Centre Orthopédique Santy, 24 Avenue Paul Santy, F-69008 Lyon, France. socoly@free.fr
Journal of Shoulder and Elbow Surgery
|March 3, 2009
Summary
Preoperative acromial issues do not impact reverse shoulder prosthesis outcomes. However, postoperative acromial spine fractures significantly worsen functional and subjective results, with uncertain treatment options.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Reconstructive Surgery
Background:
- Reverse shoulder prostheses rely heavily on intact deltoid muscle function.
- Acromial injuries, including fractures and meso-acromion, can potentially compromise deltoid function and affect surgical outcomes.
Purpose of the Study:
- To evaluate the impact of preoperative acromial pathology on outcomes following reverse shoulder arthroplasty.
- To assess the effect of postoperative acromial spine fractures on functional and subjective results.
Main Methods:
- Analysis of 457 consecutive reverse shoulder prostheses implanted between 1992 and 2003.
- Identification and categorization of 41 patients with pre-operative acromial lesions (os acromiale, acromial fracture/fragmentation, scapular spine pseudarthrosis).
Main Results:
- Preoperative acromial pathology did not negatively affect postoperative range of motion, Constant score, or subjective outcomes.
- Four patients with postoperative acromial spine fractures demonstrated significantly inferior functional and subjective results.
Conclusions:
- Preoperative acromial lesions are not contraindications for reverse shoulder arthroplasty.
- Postoperative acromial spine fractures have a substantial negative impact on patient outcomes, necessitating further investigation into optimal treatment strategies.
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