Bony Increased-Offset Reverse Shoulder Arthroplasty

Abstract

Reverse shoulder arthroplasty has proven useful in numerous pathologic conditions, such as that of pseudoparalytic shoulder with severe rotator cuff deficiency with or without collapse (so-called cuff-tear arthropathy), rheumatoid arthritis, dislocations and sequelae of proximal humerus fractures, and revision shoulder arthroplasty. Despite the advances beyond the constrained reverse prostheses of the 1970s resulting from Grammont’s principles, problems remain with current systems, with high rates of scapular notching and prosthetic instability. Lateralization of the center of rotation of the shoulder joint has been viewed as a potential solution to these persistent problems, and is included in the procedure known as bony increased-offset reverse shoulder arthroplasty. This article presents our surgical technique for this procedure and promising early results of its use.

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