Reverse shoulder arthroplasty: Evolution in design, indications, surgical technique, and associated complications

Kamal I. Bohsali, Michael A Wirth

Research output: Chapter in Book/Report/Conference proceedingChapter


In the 1970s, the reverse ball and socket design was employed for use in the clinical scenario of glenohumeral arthrosis associated with a structurally or functionally deficient rotator cuff. Implant designs from this era demonstrated minimal success due to issues related to metallurgy, lateralized center of rotation, and fixed fulcrum kinematics. Complication rates regarding semi-constrained and constrained implants approached 90 %, resulting in abandonment of these implants [1, 2]. Current implant designs have focused on a medialized center of rotation, increased glenosphere radius of curvature, modularity of components, and improved baseplate fixation options. Indications for reverse shoulder arthroplasty have continued to evolve and currently include the treatment of proximal humerus fractures, failed unconstrained total shoulder arthroplasty, rheumatoid arthritis with irreparable rotator cuff tears, tumors, and massive rotator cuff tears without arthritis [3, 4]. Despite the current implant designs, surgical technique, and rehabilitation protocols, reverse shoulder arthroplasty has continued to demonstrate complication rates that exceed that of conventional total shoulder arthroplasty [5-7]. Even with its widespread use, there remains a paucity of long-term data regarding survivorship and functional outcomes.

Original languageEnglish (US)
Title of host publicationRotator Cuff Tear: Pathogenesis, Evaluation and Treatment
PublisherSpringer International Publishing
Number of pages23
ISBN (Electronic)9783319333557
ISBN (Print)9783319333540
StatePublished - Jan 1 2016

ASJC Scopus subject areas

  • Medicine(all)


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