Reverse Shoulder Arthroplasty: A Role Defined

The recent resurgence in interest in reverse shoulder replacement catalyzed by innovations in prosthetic design over the last two decades in Europe has now reached North America. In a short period of time, the concept has emerged from relative obscurity to preeminence as one of the hot topics at orthopedic and shoulder specialty meetings worldwide. However, cautionary data have emerged from highly respected centers and surgeons regarding a relatively high complication and reoperation rate. It is important to critically examine our reaction to and use of such a new and complicated technology as reverse shoulder replacement. This submission provides a detailed look at the advantages and shortcomings of this technology, focusing on the indications and contraindications with the concept that these are the most important factors to consider. When performed cautiously in the patient with ideal indications, this prosthesis offers the potential of an excellent result where previously there was none. The reverse shoulder replacement should be saved for patients for whom there is no reasonable alternative.