Reverse Shoulder Arthroplasty
Reverse Shoulder Arthroplasty - Related Videos
10:10
Reverse Total Shoulder Arthroplasty
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Cited by 5 •
2011
Reverse total shoulder arthroplasty is indicated for the treatment of conditions that cannot be treated with conventional arthroplasty or other procedures. These primarily include degenerative and incapacitating conditions with irreparable rotator cuff and loss of the normal biomechanical coupling of the shoulder.
08:57
Shoulder Exam I
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2023
Source: Robert E. Sallis, MD. Kaiser Permanente, Fontana, California, USA Examination of the shoulder can be complex, because it actually consists of four separate joints: are the glenohumeral (GH) joint, the acromioclavicular (AC) joint, the sternoclavicular joint, and the scapulothoracic joint. The GH joint is primarily responsible for shoulder motion and is the most mobile joint in the body. It has been likened to a golf ball sitting on a tee and is prone to instability. It is held in place...
08:30
Intra-articular Shoulder Injection for Reduction Following Shoulder Dislocation
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2023
Source: Rachel Liu, BAO, MBBCh, Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA The anterior shoulder dislocation is one of the most common joint dislocations seen in emergency settings. In anterior shoulder dislocation, the humeral head is displaced out of the glenohumeral joint in front of the scapular glenoid, resulting in a loss of the articulation between the arm and the rest of the shoulder. This can be caused by a fall onto an abducted, extended, and externally...
01:23
Muscles of the Shoulder
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2024
The muscles surrounding the shoulder girdle, including the clavicle and scapula, primarily stabilize the scapula. This stable base allows other muscles to move the humerus effectively. Scapular movements often mirror those of the humerus and extend its range of motion. For instance, raising the arm above the head would not be feasible without simultaneous upward rotation of the scapula. Anterior Thoracic Muscles The anterior thoracic muscles include the serratus anterior, subclavius, and...
07:38
Shoulder Exam II
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2015
Source: Robert E. Sallis, MD. Kaiser Permanente, Fontana, California, USA The shoulder exam continues by checking the strength of the rotator cuff muscles and biceps tendons. The rotator cuff muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) act as compressors, holding the humeral head in place against the glenoid. Injury and degeneration of the rotator cuff tendons are the most common sources of shoulder pain. The strength testing of the rotator muscle is performed by...
FAQs
The key mechanical change is a shift in the shoulder’s center of rotation, which changes how the deltoid contributes to elevation. This arrangement can let the deltoid raise the arm despite reduced rotator-cuff function. Its relevance is greatest when restoring elevation would otherwise depend on a cuff that is no longer functioning adequately.
The two approaches differ in how they support arm elevation. Conventional replacement is less suitable when effective movement depends on a functioning rotator cuff, whereas the reversed construct reduces that dependence by making the deltoid more central to elevation. This distinction helps explain why the reverse approach is considered for selected cuff-related conditions.
Pain reduction is only one measure of success. Clinicians also consider implant stability, the shoulder’s range of motion, and the risk of complications. These outcomes may not improve identically, so assessment of reverse shoulder arthroplasty requires attention to both symptom relief and the functional performance and safety of the implant construct.
Cuff tear arthropathy is a major indication because the rotator cuff may no longer provide the function needed for a conventional replacement to restore elevation. Reversing the joint geometry shifts greater responsibility to the deltoid. The procedure therefore addresses a clinical situation in which pain and impaired arm elevation coexist with inadequate cuff function.
Surgeons may consider reverse shoulder arthroplasty for complex proximal humeral fractures and for revision surgery, in addition to cuff tear arthropathy. These cases represent situations in which restoring useful arm function may be difficult with a conventional replacement. The approach is also used selectively for certain degenerative shoulder conditions rather than for every patient with degeneration.
Expected clinical gains include reduced pain and improved shoulder elevation, but evaluation extends beyond those benefits. Clinicians also examine whether the implant remains stable, how much range of motion returns, and whether complications occur. Together, these measures show whether the reconstruction has provided meaningful functional improvement while maintaining an acceptable safety profile.