Reverse Total Shoulder Arthroplasty: Restoring Function

The reverse total shoulder arthroplasty (RTSA) has become increasingly popular over the past 20 years. Although the initial indications for RTSA were limited to patients with cuff tear arthropathy, more recently, the indications for this prosthesis have been expanded to include rheumatoid arthritis, trauma, revision, and tumor. Improved understanding of glenohumeral kinematics and advances in prosthetic design has resulted in improvements in midterm survivorship; however, radiographic and functional results are still a source of concern. With the recent expansion of surgical indications and issues related to implant longevity, careful patient selection and attention to surgical technique remain paramount to clinical success. In this review, we will discuss the history and evolution of the RTSA as well as advances in modern implant design.