Reverse total shoulder arthroplasty

Case contributed by Dr Matt A. Morgan

Presentation

Two different patients with reverse total shoulder arthroplasty

Patient Data

Age: 1st: 62Y, 2nd 61Y
Gender: Female

First patient

Modality: X-ray

The patient has a reverse right total shoulder prosthesis [DJO System; cemented size 8 stem with antibiotic cement and 1 gram of vancomycin added per bag of cement; 26-mm base plate with 4 interlocking screws; 32-mm minus four glenoid sphere; standard polyethylene insert and metallic segment]

There is no evidence of loosening or malalignment.

Two screws in the right acromion are also noted, and are not a typical component of the reverse total shoulder hardware.

Second patient

Modality: X-ray

The first image shows the patient's original conventional total shoulder arthroplasty.

This was revised after a joint infection to a reverse total shoulder arthroplasty arrangement (second image)

Case Discussion

The indications for reverse total shoulder arthroplasty are expanding. Originally indicated for shoulder replacement in patients with severe rotator cuff tendinopathy, the good track record of the prosthesis so far has led to it being adopted in other situations such as reconstruction after tumor surgery.

The two main advantages of the reverse total shoulder arthroplasty over the conventional arrangement are:

  • mechanically relies on the deltoid muscle for movement, so it is better for patients with rotator cuff tendinopathy
  • improved recovery time and pain scores
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Case Information

rID: 34726
Case created: 6th Mar 2015
Last edited: 9th Sep 2015
Inclusion in quiz mode: Included

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