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Related Experiment Video

Updated: Nov 16, 2025

Reverse Total Shoulder Arthroplasty
10:10

Reverse Total Shoulder Arthroplasty

Published on: July 5, 2011

43.6K

Reverse total shoulder arthroplasty.

Eleanor G Burden1, Timothy J Batten1, Christopher D Smith1

  • 1Royal Devon and Exeter Foundation Trust, Exeter, UK.

The Bone & Joint Journal
|February 22, 2021
PubMed
Summary
This summary is machine-generated.

Reverse total shoulder arthroplasty (RTSA) complication rates were similar across designs, except for higher scapular notching with medial glenoid/medial humerus (MGMH) implants. Patient-reported outcomes were comparable, indicating overall success for RTSA management of various shoulder conditions.

Keywords:
ComplicationsOutcomesRTSAReverse total shoulder arthroplasty

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Prosthetics and implants

Background:

  • Reverse total shoulder arthroplasty (RTSA) is used for debilitating shoulder conditions like osteoarthritis and rotator cuff tears.
  • Different prosthetic designs exist, categorized by glenoid and humeral component positioning: medial glenoid/medial humerus (MGMH), medial glenoid/lateral humerus (MGLH), and lateral glenoid/medial humerus (LGMH).
  • Understanding complication patterns associated with each design is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To systematically review and compare complication patterns across three distinct reverse total shoulder arthroplasty (RTSA) prosthetic designs.
  • To evaluate patient-reported outcome measures (PROMs) associated with each RTSA implant philosophy.
  • To identify design-specific risks for conditions including cuff tear arthropathy, massive cuff tear, osteoarthritis, and rheumatoid arthritis.

Main Methods:

  • A systematic literature review was conducted using MEDLINE and Embase databases.
  • Data on complications and PROMs were extracted by two independent reviewers.
  • Meta-analysis was performed on complication proportions and PROMs, with study quality assessed using Wylde's system.

Main Results:

  • 42 studies were included, analyzing MGMH, MGLH, and LGMH designs.
  • Significantly higher rates of scapular notching were observed with MGMH implants (52%) compared to MGLH (18%) and LGMH (12%).
  • Higher rates of glenoid loosening were noted in MGMH implants (6%) versus MGLH (0%), though with low evidence strength. No significant differences in other complications or PROMs were found between designs.

Conclusions:

  • All studied RTSA implant philosophies demonstrated significant improvements in PROMs and low overall complication rates.
  • Scapular notching was the only complication with a definitively higher prevalence in the MGMH implant design.
  • The findings support the efficacy of RTSA across different designs, with specific attention to mitigating scapular notching in the MGMH configuration.