An update on reverse total shoulder arthroplasty: current indications, new designs, same old problems
Thomas Kozak, Stefan Bauer, Gilles Walch, Saad Al-karawi, and William BlakeneyShoulder
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Reverse total shoulder arthroplasty (RTSA) was originally developed because of unsatisfactory results with anatomic shoulder arthroplasty options for the majority of degenerative shoulder conditions and fractures.
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After initial concerns about RTSA longevity, indications were extended to primary osteoarthritis with glenoid deficiency, massive cuff tears in younger patients, fracture, tumour and failed anatomic total shoulder replacement.
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Traditional RTSA by Grammont has undergone a number of iterations such as glenoid lateralization, reduced neck-shaft angle, modular, stemless components and onlay systems.
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The incidence of complications such as dislocation, notching and acromial fractures has also evolved.
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Computer navigation, 3D planning and patient-specific implantation have been in use for several years and mixed-reality guided implantation is currently being trialled.
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Controversies in RTSA include lateralization, stemless humeral components, subscapularis repair and treatment of acromial fractures.
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