Bony Increased Offset-Reversed Shoulder Arthroplasty (BIO-RSA).

Abstract

Bony increased offset-reversed shoulder arthroplasty (BIO-RSA) is an effective and safe means of achieving lateralization of the prosthetic center of rotation in reverse shoulder arthroplasty. Confirm the indication for surgery and obtain radiographs and 3-dimensional (3D) imaging (computed tomography [CT] or magnetic resonance imaging [MRI] scans) to confirm the suitability for a BIO-RSA. With the patient in the beach-chair position, approach the shoulder via a standard deltopectoral approach. Dislocate the humeral head anteriorly and use the instrumentation to harvest a 29-mm fully cancellous graft of desired thickness from the humeral head. Carefully and meticulously expose and prepare the glenoid for prosthetic implantation. Prepare and implant the humeral prosthesis as per the standard surgical technique described for implantation of the Aequalis Reversed prosthesis10. Postoperative management is the same as that for a nonlateralized reverse prosthesis, with no alteration in rehabilitation required. In our original series of 42 patients with a minimum follow-up of 2 years (mean, 28 months), the glenoid bone graft incorporated completely in 41 patients and partially in 1 patient (Fig. 5)6.