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Lateralization

Lateralization

Brain lateralization refers to the division of mental processes and functions between the two hemispheres of the brain, a phenomenon that optimizes neural efficiency and underpins complex abilities in humans. This specialization allows each hemisphere to perform tasks where it has a comparative advantage, facilitating more refined cognitive capabilities across different domains.

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Updated: Dec 24, 2025

Reverse Total Shoulder Arthroplasty

Reverse Total Shoulder Arthroplasty

Published on: July 5, 2011

Lateralization in reverse shoulder arthroplasty: A review.

Steve Parry¹, Shawn Stachler², Jared Mahylis¹

¹Department of Orthopaedics, Midwestern University/Franciscan Health-Olympia Fields, 20202 S, Crawford Ave, Olympia Fields, IL, 60461, USA.

Journal of Orthopaedics

|April 14, 2020

Summary

Lateralization in reverse shoulder arthroplasty improves outcomes by addressing issues like scapular notching and limited external rotation. Humeral or glenoid component lateralization offers potential benefits, though further clinical evidence is needed.

Keywords:

Biomechanics Implant design Reverse total shoulder arthroplasty

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Area of Science:

Orthopedic Surgery
Biomedical Engineering
Reconstructive Surgery

Background:

Grammont's reverse shoulder arthroplasty design revolutionized treatment for rotator cuff arthropathy and proximal humerus fractures.
The original design featured a medialized center of rotation, leading to long-term issues like scapular notching and reduced external rotation.

Purpose of the Study:

To evaluate the evolution of reverse shoulder arthroplasty design, focusing on the concept of lateralization.
To compare the biomechanical and clinical implications of glenoid versus humeral component lateralization.

Main Methods:

Review of existing literature on reverse shoulder arthroplasty designs, including Grammont and lateralized components.
Analysis of biomechanical studies investigating scapular notching and range of motion.
Discussion of clinical outcomes and concerns associated with different lateralization strategies.

Main Results:

Lateralization, moving the center of rotation laterally, aims to mitigate issues of the original Grammont design.
Glenoid component lateralization may reduce scapular notching but raises concerns about glenosphere/glenoid interface loosening.
Humeral component lateralization is theorized to enhance rotator cuff and deltoid mechanics without the loosening concerns of glenoid lateralization.

Conclusions:

Biomechanical studies suggest lateralized components (humeral or glenoid) improve scapular notching rates and post-operative external rotation.
Limited clinical evidence currently supports one lateralization approach over the other.
Future research is needed to determine the advantages of specific lateralization designs or their combinations.