Reverse Total Shoulder Arthroplasty: Current Concepts, Results, and Component Wear Analysis

by D. Nam, C.K. Kepler, A.S. Neviaser, K.J. Jones, T.M. Wright, E.V. Craig, and R.F. Warren

J Bone Joint Surg AmVolume 92(Supplement 2):23-35

December 1, 2010

©2010 by The Journal of Bone and Joint Surgery, Inc.

Both mechanical factors (left) and nutritional factors (right) contribute to joint destruction in rotator cuff-tear arthropathy.

D. Nam et al. J Bone Joint Surg Am 2010;92:23-35

©2010 by The Journal of Bone and Joint Surgery, Inc.

Clinical picture of the left shoulder in a patient with rotator cuff-tear arthropathy, demonstrating anterior (left arrow) and superior (right arrow) escape of the humeral head resulting from loss of

the subscapularis with a grossly deficient rotator cuff.

D. Nam et al. J Bone Joint Surg Am 2010;92:23-35

©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 3-A Anteroposterior radiograph of the right shoulder after a glenohumeral arthrodesis.

D. Nam et al. J Bone Joint Surg Am 2010;92:23-35

©2010 by The Journal of Bone and Joint Surgery, Inc.

Axillary view radiograph of the right shoulder, demonstrating radiolucencies surrounding the glenoid component (arrows).

D. Nam et al. J Bone Joint Surg Am 2010;92:23-35

©2010 by The Journal of Bone and Joint Surgery, Inc.

Grammont’s original reverse total shoulder arthroplasty.

D. Nam et al. J Bone Joint Surg Am 2010;92:23-35

©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 6-A and 6-B Diagrams demonstrating an earlier reverse total shoulder prosthesis design, with a small glenosphere component and a lateralized center of rotation (Fig. 6-A), versus the

modern design, with a large glenosphere, a nonanatomic valgus angle o...

D. Nam et al. J Bone Joint Surg Am 2010;92:23-35

©2010 by The Journal of Bone and Joint Surgery, Inc.

A: The seven segments of the deltoid muscle, according to Kapandji55.

D. Nam et al. J Bone Joint Surg Am 2010;92:23-35

©2010 by The Journal of Bone and Joint Surgery, Inc.

D. Nam et al. J Bone Joint Surg Am 2010;92:23-35

©2010 by The Journal of Bone and Joint Surgery, Inc.

D. Nam et al. J Bone Joint Surg Am 2010;92:23-35

©2010 by The Journal of Bone and Joint Surgery, Inc.

Quadrants and scoring system utilized for grading each damage mode.

D. Nam et al. J Bone Joint Surg Am 2010;92:23-35

©2010 by The Journal of Bone and Joint Surgery, Inc.

Photographs of retrieved humeral implants demonstrating inferior-quadrant abrasion (a, arrow) and diffuse third-body debris (b).

D. Nam et al. J Bone Joint Surg Am 2010;92:23-35

©2010 by The Journal of Bone and Joint Surgery, Inc.