Paul's Pleasures
This French surgeon introduced the modern reverse shoulder design in 1987
Who is Paul Grammont
This is the year that RTSAs were FDA approved in the US
When was 2003
This is the most common reason people in France use the RTSA
What is cuff tear arthropathy
The motion that improves most reliably after RSA.
What is forward flexion
This is the most common radiologic complication of RTSA.
What is scapular notching (occurs in about 15% of all cases)
One major criticism of the original Grammont design was that medialization increased rates of this radiographic finding.
Increasing glenosphere diameter decreases the risk of this problem
What is dislocation
In a 42 year old with a posterior superior cuff tear and Hamada II on Xrays, grade III fatty infiltration of the infraspinatus, this is the preferred treatment
What is shoulder sparing--tendon transfer, partial repair, NOT doing a RTSA right away.
At 10 years, modern RSA survivorship is approximately this percentage in large registry studies.
What is 85-95% (any range in here works)
This complication, which occurs in about 5% of cases, is more likely in osteopenic women, cuff tear arthropathy, and can result in higher dislocation rates
What is acromial stress fracture
This gentleman is credited with several of the original RTSA designs, although they failed at the glenoid
Who is Charles Neer
This surgical maneuver increases deltoid tension and stability in RSA.
What is distalization of the humerus
These are the preferred indications for doing an RTSA for primary GHOA.
What are:
•Age greater than….75?
•Stiff shoulder (FE<105)
•Goutallier greater than I in SS and IS (but we often don’t get an MRI)
•Poor soft tissue quality at time of surgery
•Challenging glenoid reconstruction
•Poor rehab candidates
When comparing outcomes of RTSA to ATSA in glenohumeral OA, this is largely considered the advantage of ATSA?
What is improved rotation (particularly ER)
These people are at higher risk for infection after RTSA. (4)
Who are diabetics, male patients, people with prior shoulder surgery, younger patients, rheumatoid, chronic corticosteroid use
When increasing the neck shaft angle from 135 to 155, this complication is thought to decrease?
What is dislocation (especially at lower flexion angles)
Lateralization of the center of rotation carries what advantages for modern RTSA?
What is decreased scapular notching and increased internal rotation
Preferred treatment of a Levy III fracture
What is scapular ORIF
This is the town Paul Grammont was born in.
What is Salins-les-Bains.
When considering inlay vs onlay techniques, this complication is thought to happen more commonly with inlay techniques even though there is no difference in clinical PROs.
What is scapular notching
This is the preferred management of a patient with proximal bone loss, a 36mm glenosphere, and an anterior dislocation
What is APC reconstruction with lateralization and larger glenosphere.