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Old 01-23-2011, 12:43 PM
Maryann Maryann is offline
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Join Date: Mar 2010
Posts: 4
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Since authoring my post above, I have had the opportunity to use the DJO Reverse prosthesis in 4 revision cases--- each performed in paients with severe pain due to worn glenoid cartilage in the aftermath of humeral replacement (hemiarthroplasty).

Because the humeral cut for this design is more varus than the cut for "Grammont design" reverse prostheses ( 130 compared to 150ish), there are 2 effects. The first is that there is less risk of scapular impingement with the arm at the side. Although it is true that the observation of "scapular notching" has not been linked to poorer functional outcomes, there is little question that a "more anatomic-- varus-- cut" also minimizes impingement at the extremes of rotation; thus, functional range of motion may indeed improve with this design.


In most cases where Reverse arthroplasty is performed, the indication is "cuff arthropathy" or an irreparable rotator cuff without arthritis. As more and more patients with failed hemiarthroplasties with in tact cuff present, the DJO design has an additional value proposition. The steeper (more anatomic) humeral cut allows preservation of the infraspinatus insertion--and this may improve functional external rotation. And, patients may have improved internal rotation (behind the back motion) as well.

I will continue to provide updates; but after 4 revisions this month alone, I am enthusiastic about improved outcomes for patients who require Reverse arthroplasty.


MERGED RELEVANT POST

As I have just had my second reverse revision shoulder replacement I invite anyone who
is contemplating this type of surgery to contact me. I have 2 very unique prosthesis, and what i consider to be the best of both worlds. My second replacement was in January
and I am now in active PT for the next 2 months. Yes, a major operation with a major
committment- but the best decision I could have made. Pain relief is so much better, and with time and plenty of effort the range of motion improves. Dr. Tomaino is the best!!!
Thanks to him I will have many years of shoulder relief. Maryann M.

Last edited by mtomaino; 03-01-2011 at 07:44 AM.
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