Offset in Reverse Shoulder Arthroplasty: Where, When, and How Much.
Citation: Journal of the American Academy of Orthopaedic Surgeons. 29(3):89-99, 2021 Feb 01.PMID: 33264136Institution: MedStar Union Memorial HospitalForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Arthroplasty, Replacement, Shoulder | *Joint Prosthesis | *Shoulder Joint | Arthroplasty, Replacement, Shoulder/ae [Adverse Effects] | Female | Humans | Male | Prosthesis Design | Range of Motion, Articular | Scapula/su [Surgery] | Shoulder Joint/su [Surgery]Year: 2021Local holdings: Available online from MWHC library: Oct 1993 - present, Available in print through MWHC library: 1999 - presentISSN:- 1067-151X
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 33264136 | Available | 33264136 |
Available online from MWHC library: Oct 1993 - present, Available in print through MWHC library: 1999 - present
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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