The Evolution of Reverse Total Shoulder Arthroplasty—From the First Steps to Novel Implant Designs and Surgical Techniques

Frank, Julia K.; Siegert, Paul; Plachel, Fabian; Heuberer, Philipp R.; Huber, Stephanie; Schanda, Jakob E.

doi:10.3390/jcm11061512

Cited by 20 publications

(14 citation statements)

References 125 publications

(207 reference statements)

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“…Currently, the implant design for rSTA is founded on the Grammont principle. This principle encompasses four key features: ( 1 ) the medially displaced center of rotation, which reduces humeral tension and increases recruitment of the anterior and posterior deltoid muscles to compensate for rotator cuff deficiency; ( 2 ) a convex weight-bearing component and concave supportive component; ( 3 ) the fixed center of rotation, which is distalized and medialized to the glenoid joint line to establish inherent implant stability; and ( 4 ) a large glenosphere to enhance the ROM via a semi-constrained implant attribute ( 18 , 19 ). However, the implementation of rTSA implant design differs in some implant details to overcome potential postoperative issues reported extensively in the current studies.…”

Section: Discussionmentioning

confidence: 99%

Global trends and research hotspots of reverse total shoulder arthroplasty: a bibliometric analysis from 1991 to 2022

Jin,

Jiang,

Pavel

et al. 2024

EFORT Open Reviews

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Reverse total shoulder arthroplasty (rTSA) has been demonstrated to be an effective intervention for various shoulder disorders. The number of rTSA-related studies performed has increased annually over the past three decades. The Journal of Shoulder and Elbow Surgery had the highest number of publications and citations in the rTSA-related research domain and is therefore considered to be the most influential journal in this field. The USA published the most publications and established a high degree of cooperation with many countries worldwide. The University of Florida, the Hospital for Special Surgery, and Rush University, Mayo Clinic were representative and active institutions in this field. It is anticipated that advancements in prosthesis design, specifically with regards to lateralized design concepts, expanding indications for rTSA, a trend toward younger patient populations, and the management of postoperative complications will emerge as research hotspots in the following years. The most valuable publications, influential journals, major researchers, and leading countries were analyzed. The findings of our study will help researchers gain insights into current research hotspots and frontiers and shape their research focus in the field of rTSA.

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Section: Discussionmentioning

confidence: 99%

Global trends and research hotspots of reverse total shoulder arthroplasty: a bibliometric analysis from 1991 to 2022

Jin,

Jiang,

Pavel

et al. 2024

EFORT Open Reviews

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“…Also, if superior and posterior screws penetrate the scapular spine, they can act as stress risers and lead to scapular fracture. Therefore, the length and direction of superior and posterior screws should be checked carefully [21][22][23]. An oval-shaped baseplate could be better for fixation, but it can be too large for Asian patients with a relatively smaller-sized glenoid [14,20,24].…”

Section: A a B Bmentioning

confidence: 99%

Implant selection for successful reverse total shoulder arthroplasty

Jeong

Won

2022

Clin Shoulder Elbow

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Reverse total shoulder arthroplasty (RTSA) emerged as a new concept of arthroplasty that does not restore normal anatomy but does restore function. It enables the function of the torn rotator cuff to be performed by the deltoid and shows encouraging clinical outcomes. Since its introduction, various modifications have been designed to improve the outcome of the RTSA. From the original cemented baseplate with peg or keel, a cementless baseplate was designed that could be fixed with central and peripheral screws. In addition, a modular-type glenoid component enabled easier revision options. For the humeral component, the initial design was an inlay type of long stem with cemented fixation. However, loss of bone stock from the cemented stem hindered revision surgery. Therefore, a cementless design was introduced with a firm metaphyseal fixation. Furthermore, to prevent complications such as scapular notching, the concept of lateralization emerged. Lateralization helped to maintain normal shoulder contour and better rotator cuff function for improved external/internal rotation power, but excessive lateralization yielded problems such as subacromial notching. Therefore, for patients with pseudoparalysis or with risk of subacromial notching, a medial eccentric tray option can be used for distalization and reduced lateralization of the center of rotation. In summary, it is important that surgeons understand the characteristics of each implant in the various options for RTSA. Furthermore, through preoperative evaluation of patients, surgeons can choose the implant option that will lead to the best outcomes after RTSA.

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“…In the RSA, the center of rotation of the shoulder is displaced inferiorly and medially. This also lengthens the moment arm and increases the deltoid force [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Reverse Shoulder Arthroplasty for Acute Proximal Humerus Fractures Treated With Trabecular Metal Prosthesis: Medium-Term Results

Viswanathan¹,

Kashyap²,

Shanker³

2023

Cureus

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IntroductionReverse shoulder arthroplasty (RSA) is becoming increasingly popular as a primary procedure for complex proximal humeral fractures (PHF) in acute trauma due to more emerging evidence and better patient outcomes. MethodsThis study is a retrospective case series of 51 patients who underwent a trabecular metal RSA for nonreconstructable, acute three or four-part PHF performed by a single surgeon between 2013 and 2019 with a minimum follow-up of three years. This included 44 females and seven males. Mean age was 76 years (range: 61-91 years). Oxford shoulder score (OSS) along with relevant patient information relating to demographics and functional outcomes were collected at regular intervals in outpatient clinic follow-ups. Complications were addressed accordingly during treatment and follow-up. ResultsThe mean follow-up duration was 5.08 years. Two patients were lost to follow-up and nine patients died due to other causes. Four of them had developed severe dementia and were excluded as an outcome score from them could not be acquired. Two patients who had surgery beyond four weeks post-injury were excluded. Thirty-four patients in total were followed up. Patients had good range of motion and mean OSS of 40.28 post-operatively. The overall complication rate was 11.7%, and none of the patients had deep infections, scapular notching, or acromial fractures. Revision rate was 5.8% at mean follow-up of five years and one month (range: three years to nine years two months). Greater tuberosity union following intra-operative repair was evident on radiographs in 61.7% of the patients. ConclusionRSA is certainly a rewarding surgery in patients with complex PHF and was associated with good postoperative OSS along with patient satisfaction, and positive radiological outcomes at minimum three-year follow-up.

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The Evolution of Reverse Total Shoulder Arthroplasty—From the First Steps to Novel Implant Designs and Surgical Techniques

Cited by 20 publications

References 125 publications

Global trends and research hotspots of reverse total shoulder arthroplasty: a bibliometric analysis from 1991 to 2022

Global trends and research hotspots of reverse total shoulder arthroplasty: a bibliometric analysis from 1991 to 2022

Implant selection for successful reverse total shoulder arthroplasty

Reverse Shoulder Arthroplasty for Acute Proximal Humerus Fractures Treated With Trabecular Metal Prosthesis: Medium-Term Results

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