Abstract
Reverse shoulder replacements are gaining popularity in recent years with good results. However, high complication rate, high incidence of glenoid notching, and significant re-operation rate are of concern. Revision surgery poses a potential serious problem in stem removal. The Verso shoulder is a stemless reverse prosthesis that differs from all other known implants. The Verso stemless reverse prosthesis is bone preserving with metaphyseal fixation and tapered screw glenoid baseplate fixation. It is a simple implant with simple surgical technique, yet with wide versatility and adaptability. Between 2005 and 2010, 102 patients were operated for severe cuff deficiency and arthritis with stemless reverse total shoulder prosthesis. The mean age at surgery was 74.4 years (range 38–93 years). The etiology for surgery was cuff arthropathy, fracture sequelae, rheumatoid arthritis, failed RC repair, revision for loosening of anatomic prosthesis or for cuff failure with anatomic prostheses and for acute trauma. Patients had good pain relief and high satisfaction score, with significant improvement of function and Constant score. The mean range of movement improved to 128.5° elevation, 50.8° external rotation, and 64.6° internal rotation. This different design, without stem, shows encouraging excellent midterm results with excellent pain relief and restoration of good active range of motion and good shoulder function. The Verso design principles seem to result in low incidence of glenoid notching and improved rotational movements with return to full activities including sports. Radiologic assessment showed only 21.4 % of glenoid notching (mainly mild), no lucencies around the implants and no signs of stress shielding. With this stemless bone preserving procedure, all options remain open for future surgery if deemed necessary as bone stock is preserved, and therefore, this prosthesis may be used in younger patients as well.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Hopkins AR, Hansen UN. Primary stability in reversed-anatomy glenoid components. Proc Inst Mech Eng. 2009;2237(7):805–12.
Nyffeler RW, Werner CM, Simmen BR, Gerber C. Analysis of a retrieved delta III total shoulder prosthesis. J Bone Joint Surg. 2004;86(8):1187–91.
Favard L, Lautmann S, Sirveaux F, et al. Hemi arthroplasty versus reverse arthroplasty in the treatment of osteoarthritis with massive rotator cuff tear. In: Walch G, Boileau P, Mole D, editors. Shoulder prosthesis two to ten year follow-up. Montpellier: Sauramps Medical; 2001. p. 261–8.
Karlse ATJA, Bhatia DN, De Wilde LF. Prosthetic component relationship of the reverse Delta III total shoulder prosthesis in the transverse plane of the body. J Shoulder Elbow Surg/Am Shoulder Elbow Surg. 2008;17(4):602–7.
Boileau P, Watkinson DJ, Hatzidakis AM, Balg F. Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elbow Surgery/Am Shoulder Elbow Surg. 2005;14(1):147S–61S.
Hasan SS, Leith JM, Smith KL, Matsen FA. The distribution of shoulder replacement among surgeons and hospitals is significantly different than that of hip or knee replacement. J Shoulder Elbow Surg/Am Shoulder Elbow Surg. 2003;12(2):164–9.
Mackenzie DB. The antero-superior exposure of a total shoulder replacement. Orthop Traumatol. 1993;2:71–7.
Levy O, Mullett H, Roberts S, Copeland S. The role of anterior deltoid reeducation in patients with massive irreparable degenerative rotator cuff tears. J Shoulder Elbow Surg/Am Shoulder Elbow Surg. 2008;17(6):863–70.
Levy O. Anterior deltoid muscle rehabilitation for massive rotator cuff tear. 2000.
Atoun E, Van Tongel A, Hous N, Narvani A, Relwani J, Abraham R, Levy O. Reverse shoulder arthroplasty with a short metaphyseal humeral stem. International orthopaedics. 2014.
Levy O, Atoun E, Narvani A, Abraham R, Hous N, Even T, Relwani J, Copeland SA, Sforza G, Tongel AV. Does reverse shoulder need a stem? 2-7 years follow-up with stemless reversed total shoulder prosthesis. American Shoulder and Elbow Surgeons 2012, Annual Meeting. The Cloister at Sea Island, Sea Island, Georgia, USA, 2012; 55–6.
Levy O, Atoun E, Narvani A, Abraham R, Hous N, Even T, Relwani J, Copeland SA, Sforza G, Tongel AV. Stemless-metaphyseal reversed prosthesis for shoulder arthropathy with severe cuff deficiency—2–7 years follow up. 24 SECEC-ESSSE Congress Dubrovnik 2012 Dubrovnik, Croatia; 2012.
Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987;214:160–4.
Gilbart MK, Gerber C. Comparison of the subjective shoulder value and the Constant score. J Shoulder Elbow Surg/Am Shoulder Elbow Surg. 2007;16(6):717–21.
Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Mole D. Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Joint Surg. 2004;86(3):388–95.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Levy, O. (2016). Verso® Stemless Bone Preserving Reverse Geometry Total Shoulder Replacement (Innovative Design Orthopaedics Ltd.) . In: Frankle, M., Marberry, S., Pupello, D. (eds) Reverse Shoulder Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-319-20840-4_39
Download citation
DOI: https://doi.org/10.1007/978-3-319-20840-4_39
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-20839-8
Online ISBN: 978-3-319-20840-4
eBook Packages: MedicineMedicine (R0)