The reverse shoulder arthroplasty is a highly technical operation. It requires appropriate soft tissue balancing and correct component positioning. When done for primary rotator cuff arthropathy has a very high success rate in restoring mobility and providing pain relief. When Paul Grammont introduced with procedure in France in the 1980s, the rest of the world saw it with scepticism and some orthopaedic surgeons had concerns. Today, it provides solutions for problems that we did not have a solution before. Below are the radiographs of a patient that has primary rotator cuff arthropathy, the patient is an elderly individual 70 years or older.
Postoperative radiographs show a press fit stem, inferior placement of the glenosphere and overhanging inferiorly by 2mm to avoid notching. Inferior tilting of the glenoid component is seen as well.
The superior screw at the 12 o'clock position is aiming towards the base of the coracoid, the inferior 6 o'clock screw is aiming to the spine of the scapula. The posterior screw is aimed inferiorly and anteriorly and the anterior screw superiorly and posteriorly. These are important details that achieve appropriate implantation and seating of the glenosphere which is the most critical aspect of this surgery.
Correct position of the glenosphere
The axillary view shows the appropriate orientation of the glenosphere.
