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Online ISSN 1827-1707
102nd CONGRESS OF THE PIEMONTESE-LIGURIAN-LOMBARD SOCIETY OF ORTHOPEDICS AND TRAUMATOLOGY (S.P.L.L.O.T.) - Brescia September 9-10, 2005
NEW TECHNOLOGIES, MODERN INSTRUMENTARIUM IN ARTHROPLASTIC SURGERY
UPDATES ON SHOULDER ARTHROPLASTY
Divisione di Ortopedia e Traumatologia Azienda Ospedaliera di Cremona, Cremona
The cuff tear arthropaty causes special degenerative changes in a shoulder. The disappearance of the rotation centre of the humeral head due to a cuff insufficiency, causes a subacromial dislocation of the joint with degenerative changes in articular surfaces, pain and loss of active and passive motion. A standard implant cannot solve the problem because of the unadjustability of the cuff. After a series of international attempts with vinculated implants, Grammont proposed a reverse one, that fixed the rotation centre and retensioned the deltoid fibers, increasing the deltoid lever arm. The implant can be done through a delto-pectoral approach or through a lateral trans-deltoid one. About the indications, pain and loss of motion are the principal. The age is important, because is doubtful to implant a reverse prosthesis in a young Patient. Fractures are an interesting developing area. The principal contraindication is the deltoid insufficiency.