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Related Experiment Video

Updated: Mar 16, 2026

Reverse Total Shoulder Arthroplasty
10:10

Reverse Total Shoulder Arthroplasty

Published on: July 5, 2011

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Current Controversies in Reverse Total Shoulder Arthroplasty.

Jessica L Churchill1, Grant E Garrigues2

  • 1Eastern Virginia Medical School, Norfolk, Virginia.

JBJS Reviews
|August 4, 2016
PubMed
Summary

Reverse total shoulder arthroplasty design choices impact outcomes. Optimal glenosphere placement and inclination are debated, with trade-offs affecting complications like scapular notching and baseplate failure.

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Area of Science:

  • Orthopedic surgery
  • Biomechanical engineering
  • Medical device design

Background:

  • Reverse total shoulder arthroplasty (RTSA) improves function and quality of life in patients with pseudoparalytic shoulders.
  • Controversies exist regarding optimal RTSA design and implantation techniques, particularly glenosphere positioning and center of rotation.

Purpose of the Study:

  • To review current evidence on glenosphere medialization versus lateralization in RTSA.
  • To evaluate the impact of glenosphere placement (caudal vs. superior) and tilt on RTSA outcomes.
  • To discuss the implications of humerosocket inclination angles on RTSA complications.

Main Methods:

  • Literature review and meta-analysis of existing studies on RTSA design and outcomes.
  • Comparative analysis of medialized versus lateralized glenosphere designs.
  • Examination of the effects of glenosphere positioning and tilt on patient outcomes and implant survival.

Main Results:

  • Medialized glenospheres reduce loosening but increase scapular notching; lateralized designs decrease notching but risk baseplate failure.
  • Caudal glenosphere placement enhances range of motion and reduces notching.
  • Superior baseplate positioning/tilt correlates with increased failure rates.

Conclusions:

  • No definitive conclusion on glenosphere medialization vs. lateralization due to trade-offs.
  • Caudal placement is beneficial, while superior placement should be avoided.
  • Further research is needed to determine optimal humerosocket inclination and tilt for RTSA.