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A History of Reverse Total Shoulder Arthroplasty

  • Symposium: Reverse Total Shoulder Arthroplasty
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

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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Authors and Affiliations

  1. Leni & Peter May Department of Orthopaedic Surgery, Mount Sinai School of Medicine, 5 East 98th Street, Box 1188, New York, NY, 10029, USA

    Evan L. Flatow MD & Alicia K. Harrison MD

Authors
  1. Evan L. Flatow MD
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  2. Alicia K. Harrison MD
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Corresponding author

Correspondence to Evan L. Flatow MD.

Additional information

Dr. Flatow is a consultant for Zimmer, Inc (Warsaw, IN) and receives royalties from Zimmer, Inc, and Innomed, Inc (Savannah, GA). Dr. Harrison certifies that she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

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Flatow, E.L., Harrison, A.K. A History of Reverse Total Shoulder Arthroplasty. Clin Orthop Relat Res 469, 2432–2439 (2011). https://doi.org/10.1007/s11999-010-1733-6

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