Reverse Shoulder Arthroplasty

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Evolution of Reverse Shoulder Arthroplasty

The development of locking plate technology established a gold-standard for proximal humerus fracture fixation, however the treatment was still limited to an acceptable fracture reduction and relying on that bone to heal, making it not ideal in older patients. Another option is replacing the humeral head with a spherical metal implant and allowing the implant to articulate with the native concave glenoid fossa. In patients that also have ineffective rotator cuffs- either from longstanding tendinopathy or from an irreparable tuberosities- the solution is to revere the natural concave-convex relationship in the shoulder. A metal hemisphere is implanted on the scapular side while a concave implant is used on the humerus side, the deltoid muscle now has a longer fulcrum and greater mechanical advantage, eliminating the necessity for the rotator cuff muscles.

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