Advertisement for orthosearch.org.uk
Orthopaedic Proceedings Logo

Receive monthly Table of Contents alerts from Orthopaedic Proceedings

Comprehensive article alerts can be set up and managed through your account settings

View my account settings

Visit Orthopaedic Proceedings at:

Loading...

Loading...

Full Access

General Orthopaedics

LATERALISATION IN REVERSE TOTAL SHOULDER ARTHROPLASTY: BONE GRAFT AND A LONG STEM OUTDISTANCES METAL – AFFIRMS

The Current Concepts in Joint Replacement (CCJR) Spring Meeting, Las Vegas, May 2017.



Abstract

Reverse TSA initially followed Grammont's dictum that the center of rotation (COR) must be in the bone (“medial” COR). Others have argued for a more lateral COR, which can be a challenge if glenoid bone stock has been medially eroded. When bone loss must be made up, and/or the COR lateralised, the options include use of bone graft or use of metal.

Metal constructs produce a cantilever-loading situation, with substantial bending moments applied to the bone-implant junction. Use of bone graft allows remodeling with living bone, so that ultimately the forces are applied to the bone-implant junction in a more compressive pattern.

The author's preference is to have at least 30% of the circumference of the baseplate contact living bone while the rest may be made up with bone graft which can remodel. It is important to have a deep keel penetrate the cortex medially.