AANA Lab Course 906- Técnicas Avanzadas de Cirugía de Hombro-Plataforma glenoidea_ aspectos del diseño y detalles técnicos para su implantación-Jose Francisco Soza Rex, MD

Plataforma glenoidea_ aspectos del diseño y detalles técnicos para su implantación-Jose Francisco Soza Rex, MD

Pdf Summary

This presentation by Dr. Jose Francisco Soza Rex focuses on the design and technical details for implanting the glenoid baseplate in reverse shoulder arthroplasty (RSA). The key objective is to understand the biomechanics of the glenoid base and how its placement affects function. The balance involves achieving biomechanical gains while minimizing loss of specific shoulder functions.<br /><br />The reverse shoulder prosthesis (Grammont design) aims to improve deltoid muscle recruitment to compensate for rotator cuff deficiencies. Different scenarios of center of rotation (COR) placement—medial or lateral on the glenoid and humerus—affect muscle forces, stability, and complication risks like scapular notching. Repairing the subscapularis muscle plays a varying role depending on these configurations.<br /><br />Optimizing RSA involves careful positioning of the glenoid component with respect to inferior placement, version, and inclination angles, as well as selecting appropriate size and augmentation to address bone defects. The humeral component’s neck-shaft angle, version, and offset are also important considerations.<br /><br />Mechanical stability of the baseplate interface is critical. Use of a 6.5 mm central compressive screw and inferior tilt of about 10º enhance fixation by reducing micromotion. Preoperative 3D planning and simulations (including range of motion and impingement analysis) inform optimal component orientation, balancing lateralization and distalization angles (LSA and DSA) to improve active external rotation and forward elevation.<br /><br />Glenoid augmentation (10º, 20º, or 30º) can lateralize COR and preserve bone stock when significant defects exist. Surgical technique emphasizes careful capsular release, protection of the axillary nerve, and use of guides or patient-specific instrumentation for accurate reaming and implant placement.<br /><br />In conclusion, understanding glenoid biomechanics and precise implantation techniques are essential to maximize functional outcomes in RSA.

Keywords

reverse shoulder arthroplasty

glenoid baseplate

biomechanics

center of rotation

Grammont design

subscapularis repair

implant positioning

mechanical stability

glenoid augmentation

3D preoperative planning