Wednesday, July 25, 2012

Know your reverse system

Reverse total shoulders are complex and each design has special elements and technical steps that are essential to its proper function. With the increase in popularity of this procedure we are seeing a growing number of technical issues with different prostheses. As an example, a patient had this prosthesis inserted by another surgeon.
The postoperative films, shown below, look fine at first glance, but suggest that the glenosphere may not be fully seated on the base plate.

Within a month the glenosphere came loose and required surgical replacement.
The shoulder did well for two years, but then pain increased and active use was lost. The x-rays below show dissociation of the humeral cup from the humeral stem.

The point is that each system has its particular characteristics and that the surgeon needs to be familiar with them.


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