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Updated: Jun 23, 2026

Reverse Total Shoulder Arthroplasty
10:10

Reverse Total Shoulder Arthroplasty

Published on: July 5, 2011

Reverse total shoulder arthroplasty.

Christian Gerber1, Scott D Pennington, Richard W Nyffeler

  • 1Department of Orthopaedic Surgery, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.

The Journal of the American Academy of Orthopaedic Surgeons
|May 5, 2009
PubMed
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Reverse total shoulder arthroplasty offers a successful salvage option for severe rotator cuff deficiency, improving function in challenging cases. However, higher complication rates necessitate careful patient selection and surgical technique.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Reconstructive Surgery

Background:

  • Historically, reverse ball-and-socket total shoulder prostheses had poor outcomes.
  • Severe rotator cuff deficiency and pseudoparalysis presented significant treatment challenges.

Purpose of the Study:

  • To evaluate the effectiveness of modern reverse total shoulder arthroplasty (RTSA) as a salvage implant.
  • To identify the biomechanical factors contributing to the success of RTSA.
  • To assess the complication rates and long-term outcomes of RTSA.

Main Methods:

  • Analysis of biomechanical design changes in RTSA since the mid-1980s.
  • Review of clinical and radiographic outcomes in patients with pseudoparalytic, rotator cuff-deficient shoulders treated with RTSA.

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Published on: June 6, 2025

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Last Updated: Jun 23, 2026

Reverse Total Shoulder Arthroplasty
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Published on: July 5, 2011

Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
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Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft

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  • Comparison of complication rates with conventional shoulder arthroplasty.

    • Main Results:

    • Modern RTSA design, featuring medialized/distal center of rotation and a large glenoid hemisphere, yields successful short- to mid-term results.
    • RTSA enables salvage of previously untreatable shoulder injuries.
    • Complication rates are approximately three times higher than conventional arthroplasty, with potential long-term deterioration of results.

    Conclusions:

    • RTSA is a valuable salvage implant for specific complex shoulder conditions.
    • Optimal patient selection and meticulous surgical technique are crucial for mitigating the high complication rate.
    • Further research is needed to address long-term outcomes and reduce complications.