9. "If at first the idea is not absurd, then there is no hope
for it."
10.
11. "Get a good idea and stay with it. Dog it, and
work at it until it’s done right."
- Walt Disney
12. Grammont Type Reverse
(France 1987)
Grammont P, Trouilloud P, Laffay JP, et al. Etude et realisation d’unenouvelle
prothe`sed’e`paule.Rheumatologie. 1987;39:407–418. [French]
13. EARLY RESULTS
Sirveaux JBJS Br 2004 – Delta III
• 80 shoulders
• 44 mo f/u average
• 92.5% satisfied
• Elevation improved 73 to 138
• 64% scapular notching
Frankle et al JBJS Aug 2005 – Encore RSP
• 60 shoulders
• 33 mo f/u
• 95% satis
• Elevation improved 55 to 105
• No scapular notching
18. PROBLEMS & COMPLICATIONS RSA
• Scapular notching 35.4%
• Instability 4.7%
• Infection 3.8%
• Glenoid loosening 3.5%
• Hematoma
• Acromial insufficiency fracture 1.5%
• Humeral loosening 1.3%
• Humerus fx 1.4%
• Neuropraxia 1.2%
• Glenoid disassembly Humeral disassembly
• Polyethylene dislocation
Matthias A. Zumstein, MDa,b, Miguel Pinedo, MDa,d, Jason Old, MD, FRCSCa,c, Pascal
Boileau, MDa,* Problems, complications, reoperations, and revisions in reverse total
shoulder arthroplasty: A systematic review. J Shoulder Elbow Surg (2011) 20, 146-157
19. • Problems 44%
• Complications 24%
• Reoperations 3.5%
• Revisions after 10%.
Matthias A. Zumstein, MDa,b, Miguel Pinedo, MDa,d, Jason Old, MD, FRCSCa,c, Pascal
Boileau, MDa,* Problems, complications, reoperations, and revisions in reverse total
shoulder arthroplasty: A systematic review. J Shoulder Elbow Surg (2011) 20, 146-157
PROBLEMS & COMPLICATIONS RSA
20.
21.
22.
23.
24.
25.
26. Lieven F de Wilde, Didier Poncet, Bart Middernacht, and Anders Ekelund
Prosthetic overhang is the most effective way to prevent scapular conflict in a
reverse total shoulder prosthesis. Acta Orthopaedica 2010; 81 (6): 719–726
27.
28. RESULTS
Smith CD, Guyver P, Bunker TD. Indications for reverse shoulder replacement: a
systematic review. J Bone Joint Surg Br. 2012 May;94(5):577-83