MedStar Authors catalog › Details for: Offset in Reverse Shoulder Arthroplasty: Where, When, and How Much.
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Offset in Reverse Shoulder Arthroplasty: Where, When, and How Much.

by Wright, Melissa A; Murthi, Anand M.
Citation: Journal of the American Academy of Orthopaedic Surgeons. 2020 Dec 01.Journal: The Journal of the American Academy of Orthopaedic Surgeons.Published: ; 2020ISSN: 1067-151X.Full author list: Wright MA; Murthi AM.UI/PMID: 33264136.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Union Memorial HospitalActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: https://dx.doi.org/10.5435/JAAOS-D-20-00671 (Click here) Abbreviated citation: J Am Acad Orthop Surg. 2020 Dec 01.Local Holdings: Available online from MWHC library: Oct 1993 - present, Available in print through MWHC library: 1999 - present.Abstract: Since the advent of Paul Grammont medialized reverse shoulder prosthesis in the 1980s, shoulder surgeons have had a reliable option for treating glenohumeral joint disease in the rotator cuff-deficient shoulder. However, the prosthesis is not without complications, including scapular notching, instability, and limited rotational motion. Implants have been modified from the original design in an effort to reduce the risk of these complications. Increasing the offset, or lateralization, of the glenosphere may reduce the rate of scapular notching, reduce impingement, increase stability, and improve rotational motion. However, a more lateralized glenosphere could lead to baseplate loosening, decreased deltoid efficiency, and increased risk of acromial fracture. Increasing the offset on the humeral side, rather than the glenosphere side, may be able to reduce the rate of scapular notching and improve rotational motion without an increased risk of baseplate loosening. Humeral lateralization also improves tension of the rotator cuff and maintains good deltoid efficiency. However, humeral lateralization provides little stability benefit, and acromial fracture remains a risk. Ultimately, the surgeon must be familiar with the implants he or she is using and the options for both glenosphere and humeral lateralization to ensure that risks and benefits can be weighed for each patient.

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