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Reverse Total Shoulder Arthroplasty

Reverse Total Shoulder Arthroplasty

Published on: July 5, 2011

Six-year experience with the Delta III reverse shoulder prosthesis.

Federico Alberto Grassi¹, Luigi Murena, Federico Valli

¹Department of Orthopaedics and Traumatology, University of Insubria, Varese, Italy.

Journal of Orthopaedic Surgery (Hong Kong)

|September 2, 2009

Summary

The Delta III reverse prosthesis improved shoulder function in elderly patients with severe joint impairment, but long-term implant survival is a concern due to progressive scapular notching.

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Area of Science:

Orthopedic surgery
Biomedical engineering
Arthroplasty

Background:

Reverse shoulder arthroplasty is a treatment option for complex shoulder conditions.
The Delta III prosthesis is a specific implant used in reverse shoulder arthroplasty.
Understanding the clinical and radiographic outcomes of this prosthesis is crucial for patient care.

Purpose of the Study:

To evaluate the clinical and radiographic results of the Delta III reverse prosthesis.
To identify complications associated with the Delta III prosthesis.
To assess patient satisfaction following implantation of the Delta III prosthesis.

Main Methods:

A cohort of 26 patients (24 women, 2 men) aged 62-84 years received the Delta III reverse prosthesis.
Diagnoses included massive rotator cuff tears, complex proximal humerus fractures, and failed previous arthroplasty.

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Clinical outcomes were assessed using the Constant scale and range of motion (ROM) measurements. Radiographs evaluated scapular notching and radiolucent lines. Patient interviews determined satisfaction.

Main Results:

Follow-up averaged 42 months for 23 patients. Significant improvement was noted in active elevation and Constant scores.
Two patients required revision surgery for glenoid component loosening. No infections, instability, or acromial fractures occurred.
Scapular notching severity progressed over time. Patient satisfaction was high, with 15 fully satisfied, but pain was reported by 10 patients.

Conclusions:

The Delta III prosthesis can restore shoulder function, particularly in elderly patients with severe glenohumeral joint impairment.
Biomechanical limitations exist, with progressive scapular notching posing a significant concern for long-term implant survival.
Careful patient selection is recommended, focusing on elderly individuals with significant joint degeneration.