Rationale, Technique, and Results of the DJO Surgical Reverse Total Shoulder Arthroplasty

Abstract

Reverse shoulder arthroplasty for the treatment of rotator cuff-deficient shoulders has improved patient outcomes compared with previous treatment options. Improvements in prosthetic design have resulted from parallel biomechanical and clinical research efforts that have provided an evidence-based foundation. Improving component fixation and positioning, providing differing prosthetic sizes and geometries, and maintaining normal humeral neck shaft angle and retroversion have allowed a decrease in prosthetic-related complications, such as mechanical failure, impingement, and instability while allowing consistent improvements in shoulder function. Clinical and biomechanical research will be discussed which has provided the design rationale for the Reverse Shoulder Prosthesis (DJO Surgical, Austin, TX), formerly known as the Encore Reverse Shoulder Prosthesis. Specifically, we will focus on: (1) baseplate fixation with a central fixed lag screw and peripheral locked screws, (2) tilting the glenoid component, (3) glenospheres with center of rotation close to anatomic (lateral to the surface of the glenoid), and (4) humeral component with an anatomic neck shaft angle.