Mechanical complications and fractures after reverse shoulder arthroplasty related to different design types and their rates: part I

Abstract

The initial reverse shoulder arthroplasty (RSA), designed by Paul Grammont, was intended to treat rotator cuff tear arthropathy in elderly patients. In the early experience, high complication rates (up to 24%) and revision rates (up to 50%) were reported. The most common complications reported were scapular notching, whereas clinically more relevant complications such as instability and acromial fractures were less commonly described. Zumstein et al defined a ‘complication’ following RSA as any intraoperative or postoperative event that was likely to have a negative influence on the patient’s final outcome. High rates of complications related to the Grammont RSA design led to development of non-Grammont designs, with 135 or 145 degrees of humeral inclination, multiple options for glenosphere size and eccentricity, improved baseplate fixation which facilitated glenoid-sided lateralization, and the option of humeral-sided lateralization. Improved implant characteristics combined with surgeon experience led to a dramatic fall in the majority of complications. However, we still lack a suitable solution for several complications, such as acromial stress fracture. Cite this article: EFORT Open Rev 2021;6:1097-1108. DOI: 10.1302/2058-5241.6.210039