The reverse
shoulder prosthesis is a
prosthesis that has been in clinical use in Europe since 1985 and was approved for use in the United States in 2004. This unique
prosthesis has a baseplate attached to the glenoid, which holds a spherical component, while the humeral component includes a
polyethylene insert that is flat. This design is the "reverse" configuration of that seen with a conventional
arthroplasty, in which the spherical component is part of the humeral component. The indications for the reverse
prosthesis are: (1) painful
arthritis associated with irreparable
rotator cuff tears (
cuff tear arthropathy), (2) failed
hemiarthroplasty with irreparable
rotator cuff tears, (3) pseudoparalysis due to massive, irreparable
rotator cuff tears, (4) some reconstructions after
tumor resection, and (5) some fractures of the shoulder not repairable or reconstructable with other techniques. This
prosthesis can produce a significant reduction in
pain and some improvement in function for most of the indications mentioned. However, the unique configuration and the challenge of its insertion can result in a high incidence of a wide variety of unusual complications. Some of these complications, such as dislocation of the components, are similar to conventional shoulder replacement. Other complications, such as notching of the scapula and acromial
stress fractures, are unique to this
prosthesis.
CONCLUSION: The configuration of the reverse
prosthesis, its normal radiographic appearance and potential complications associated with its use are reviewed.