Optimizing glenosphere position and fixation in reverse shoulder arthroplasty, Part Two: The three-column concept

The effect of component positioning on intrinsic stability of the reverse shoulder arthroplasty

“…In this particular configuration, the hole on the surface of the glenoid component for the central screw that fixes the glenosphere to the base plate is very close to the border of the polyethylene cup, and may affect the contacts between the two components. The clinical consequence is that positioning of the glenosphere can be focused on optimizing fixation (by maximizing screw length, accomplishing far cortical fixation, attaining screw purchase in good bone stock and avoiding undesirable tensile forces on the metaglene/baseplate interface and screws 16,19 ) without regards to the future joint stability. This is especially helpful in case of poor glenoid bone stock, where the version of the glenosphere can be slightly adapted from 10° retroversion to 20° anteversion to profit from the best bone available.…”

How Reverse Shoulder Arthroplasty Works

“…Chebli et al emphasized the importance of glenoid fixation and peripheral screw placement into the highest quality glenoid bone stock [10]. This bone stock can be found in the three major columns of scapular bone, as described by Humphrey et al They emphasize placing peripheral screws into the base of the coracoid, the spine of the scapula, or the scapular pillar [39]. However, as a result of the varied spectrum of disease seen in CTA, these optimal locations are not always readily available for fixation.…”

Reverse Total Shoulder Arthroplasty: Where we are? "Principles"

“…Nyffeler와 그의 동료들은 관절와 패임 (scapula notching)을 줄이기 위해 관절와 기구 (glenoid component)를 좀 더 원래의 관절와 하연보다 하방으로 위 치시켰다. 26,27) Simovitch는 glenospheres를 약간은 하방으로 경사 (tilt)하고 offset을 주어야 하는지 임상적인 중요성과 디자인의 당위성에 대해 증명하였다. …”