Reverse Total Shoulder Arthroplasty

Wall, Bryan; Nové-Josserand, Laurent; O’Connor, Daniel P.; Edwards, T. Bradley; Walch, Gilles

doi:10.2106/jbjs.f.00666

Cited by 615 publications

(512 citation statements)

References 30 publications

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“…The indications for RTSA have expanded over the last few years and include CTA [15,18,26,50,57,61], inflammatory arthropathy with massive rotator cuff tear [26,45], proximal humeral nonunion or malunion [6,34,57], acute fractures [34,57,58], fixed glenohumeral dislocation [57], posttraumatic arthritis [26,57], tumor [4,13,35,57], revision arthroplasty [6,27,33,57], and chronic pseudoparalysis without arthritis [41,57,60,61]. We will limit our discussion to problems dealing with the rotator cuff.…”

Section: Indications For Reverse Total Shoulder Arthroplastymentioning

confidence: 99%

“…The RTSA was originally designed to treat a massive irreparable rotator cuff with superior migration of the humeral head combined with glenohumeral arthritis (cuff tear arthropathy [CTA]) [5,15,18,21,40]. The indications have expanded however, and currently it is being used for multiple diagnoses including fracture sequelae [6,31,32,34,58], revision arthroplasty [6,27,33,57], instability [57], and tumors [4,13,35,57]. As a result of its success with these problems, its indications are gradually increasing, and many are unsure about its role in the treatment of rotator cuff disease.…”

Section: Introductionmentioning

confidence: 99%

“…Rotator cuff tear arthropathy is the single most common indication for RTSA [57]. Clinical findings are variable and depend largely on the degree of arthritis and the specific rotator cuff tendons torn.…”

Section: Introductionmentioning

confidence: 99%

“…5) [41,57,60,61]. These patients have full passive forward elevation but a loss of active elevation as a result of the inability of the rotator cuff to provide a fulcrum for the deltoid during elevation.…”

Section: Introductionmentioning

confidence: 99%

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Indications for Reverse Total Shoulder Arthroplasty in Rotator Cuff Disease

Drake¹,

O’Connor

Edwards

2010

Clinical Orthopaedics &Amp; Related Research

220

129

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Background Reverse total shoulder arthroplasty (RTSA) was introduced to treat rotator cuff tear arthropathy but is now used to treat a variety of problems. Although its use has expanded substantially since the FDA's approval in 2004, the appropriateness in patients with rotator cuff disease is unclear. Questions/purposes We review the use of RTSA in patients with rotator cuff disease to (1) describe classification of rotator cuff tear reparability and the concept of a balanced shoulder; (2) explore the theory behind RTSA design relative to rotator cuff arthropathy; (3) discuss the indications and contraindications for RTSA; and (4) review published outcomes of RTSA for rotator cuff arthropathy.Methods We performed a selective review of the literature on the use of RTSA in the treatment of rotator cuff disease.Results Modern RTSA designs restore deltoid tension and a functional fulcrum to the rotator cuff deficient shoulder, which allows recovery of active shoulder elevation and effectively restores function in short-and mediumterm followup studies. Conclusions In short-term followup the RTSA relieves symptoms and restores function for patients with cuff tear arthropathy and irreparable rotator cuff tears with pseudoparalysis (preserved deltoid contraction but loss of active elevation). Severely impaired deltoid function, an isolated supraspinatus tear, and the presence of full active shoulder elevation with a massive rotator cuff tear and arthritis are contraindications to RTSA. Clinical Relevance For properly selected patients who have symptomatic and disabling rotator cuff deficiency, RTSA can result in life-changing improvements in pain, motion, function, and patient satisfaction. Level of Evidence Level V therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Section: Indications For Reverse Total Shoulder Arthroplastymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Indications for Reverse Total Shoulder Arthroplasty in Rotator Cuff Disease

Drake¹,

O’Connor

Edwards

2010

Clinical Orthopaedics &Amp; Related Research

220

129

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“…These indications and contraindications continue to be debated, such as how one defines pseudoparalysis and at what age a patient is ''too young'' for a reverse shoulder arthroplasty. The improved outcomes possible with this prosthesis have been well documented [18,45,47,48]. The improvements in pain and ROM have therefore made reverse arthroplasty an increasingly commonly selected option for patients and subject for study.…”

Section: Discussionmentioning

confidence: 99%

A History of Reverse Total Shoulder Arthroplasty

Flatow

Harrison

2011

Clinical Orthopaedics &Amp; Related Research

189

108

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Background Management of the cuff-deficient arthritic shoulder has long been challenging. Early unconstrained shoulder arthroplasty systems were associated with high complication and implant failure rates. The evolution toward the modern reverse shoulder arthroplasty includes many variables of constrained shoulder arthroplasty designs. Questions/purposes This review explores the development of reverse shoulder arthroplasty, specifically describing (1) the evolution of reverse shoulder arthroplasty designs, (2) the biomechanical variations in the evolution of this arthroplasty, and (3) the current issues relevant to reverse shoulder arthroplasty today. Methods Using a PubMed search, the literature was explored for articles addressing reverse shoulder arthroplasty, focusing on those papers with historical context. Results Results of the early designs were apparently poor, although they were not subjected to rigorous clinical research and usually reported only in secondary literature. We identified a trend of glenoid component failure in the early reverse designs. This trend was recognized and reported by authors as the reverse shoulder evolved.Authors reported greater pain relief and better function in reverse shoulder arthroplasty with the fundamental change of Grammont's design (moving the center of rotation medially and distally). However, current reports suggest lingering concerns and challenges with today's designs. Conclusions The history of reverse shoulder arthroplasty involves the designs of many forward-thinking surgeons. Many of these highly constrained systems failed, although more recent designs have demonstrated improved longevity and implant performance. Reverse shoulder arthroplasty requires ongoing study, with challenges and controversies remaining around present-day designs.

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Emerging Arthroplasties

Peck¹

2012

Advances in Small Animal Total Joint Replacement

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Reverse Total Shoulder Arthroplasty

Cited by 615 publications

References 30 publications

Indications for Reverse Total Shoulder Arthroplasty in Rotator Cuff Disease

Indications for Reverse Total Shoulder Arthroplasty in Rotator Cuff Disease

A History of Reverse Total Shoulder Arthroplasty

Emerging Arthroplasties

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