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Reverse Total Shoulder Arthroplasty
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Reverse Total Shoulder Arthroplasty

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Reverse Total Shoulder Arthroplasty: Technique, Decision-Making and Exposure Tips.

Harshvardhan Chawla1, Seth Gamradt2

  • 1Sports Medicine Service, Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 1520 San Pablo Street, Suite 2000, Los Angeles, CA, 90033, USA.

Current Reviews in Musculoskeletal Medicine
|March 10, 2020
PubMed
Summary

This review offers surgical decision-making strategies for reverse shoulder arthroplasty (RSA). Key findings emphasize optimizing surgical exposure through specific techniques for improved outcomes in complex cases.

Keywords:
Glenoid exposure, lateralized prosthesisIndicationsPreoperative planningReverse shoulder arthroplastyReverse shoulder replacement

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering

Background:

  • Reverse shoulder arthroplasty (RSA) technology has advanced, offering new prosthetic options.
  • Indications for RSA include rotator cuff disease, deformity, bone loss, and instability.

Purpose of the Study:

  • To present surgical decision-making pearls for reverse shoulder arthroplasty.
  • To describe methods for optimizing surgical exposure during RSA procedures.

Main Methods:

  • Review of current literature and surgical techniques for RSA.
  • Analysis of critical steps for humeral and glenoid exposure.

Main Results:

  • Principles of humeral and glenoid exposure remain consistent despite technological advancements.
  • Optimal exposure involves releasing deltoid adhesions, removing osteophytes, making generous humeral head cuts, performing thorough capsular release, and strategic glenoid retractor placement.
  • Neuromuscular paralysis can facilitate glenoid exposure.

Conclusions:

  • Effective surgical exposure is crucial for successful reverse shoulder arthroplasty.
  • Adherence to established exposure principles ensures optimal outcomes in RSA.