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General Orthopaedics

DETERMINING OPTIMAL GLENOSPHERE OFFSET IN RSA: NEWTONIAN NIGHTMARE

Current Concepts in Joint Replacement (CCJR) – Spring 2014



Abstract

Is there an optimal way to place a glenoid in reverse total shoulder arthroplasty (RTSA)? Four of the six parameters that a surgeon can control in a RTSA involve the glenoid. The parameters are: inferior tilt, increased lateral or inferior offset and increased glenosphere diameter. The theoretical challenges are further complicated by the normal variations that exist in the bony anatomy of the scapula and pathological abnormalities prevalent in as many as 40% of patients undergoing RTSA. Over the last 5 years there has been a growing body of data and study on the biomechanics, clinical outcomes and complications of this prosthesis. What have we learned? How does a surgeon incorporate this into their practice? The goal of this talk is to briefly review the current status of biomechanics on the impact of glenosphere positioning and offset on the outcome of reverse arthroplasty.