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History of Reverse Shoulder Arthroplasty

  • Giuseppe FamaEmail author
  • Assunta Pozzuoli
Chapter

Abstract

Reverse shoulder arthroplasty replaces the normal glenoid socket with a “glenosphere” fixed to the scapular neck and articulated with a polyethylene socket of the humeral component.

Over the last two decades, the use of reverse total shoulder arthroplasty has exponentially increased worldwide to manage cuff-deficient and arthritic shoulders that could not be adequately treated in the past. The concept of the reverse shoulder prosthesis was introduced in the 1970s. The evolution toward the modern designs includes many variables of constrained shoulder prostheses, but these first systems were associated with high complication rates and implant failures.

Paul Grammont first introduced two revolutionary biomechanical innovations which led to the success of reverse shoulder prosthesis: the shift of the center of rotation medially and distally by means of a large glenoid hemisphere without the neck and a small humeral cup covering less than half of the hemisphere and almost horizontally inclined. The Grammont reverse shoulder prosthesis leads to greater deltoid stretch that induces a vicarious function of the deficient rotator cuff muscles and, consequently, improves function and stability of the shoulder joint. The development of the Grammont reverse shoulder arthroplasty, Delta prosthesis, has been fundamental to all the modern generations of reverse shoulder systems that continue to evolve on Grammont’s concepts. However, current reports suggest the promising results of these new prostheses, but some concerns and controversies have still to be solved.

A historical review of the evolution of reverse shoulder arthroplasty is presented.

Keywords

Reverse prosthesis History Arthroplasty Shoulder Shoulder arthritis Cuff deficiency 

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Orthopaedic ClinicAzienda Ospedaliera-University of PadovaPadovaItaly
  2. 2.Department of Orthopaedics and Orthopaedic OncologyUniversity of PadovaPadovaItaly

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