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Tesi etd-06102016-123028


Thesis type
Tesi di specializzazione (5 anni)
Author
BUGELLI, GIULIA
URN
etd-06102016-123028
Title
MINIMALLY INVASIVE SURGERY IN REVERSE SHOULDER ARTHROPLASTY: 100 CASES OF TISSUE SPARING ANTERO SUPERIOR APPROACH
Struttura
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Corso di studi
ORTOPEDIA E TRAUMATOLOGIA
Commissione
relatore Prof. Guido, Giulio
Parole chiave
  • Reverse shoulder arthroplasy
  • Antero superior approach
  • minimally invasive surgery
  • tissue sparing approach
Data inizio appello
30/06/2016;
Consultabilità
parziale
Data di rilascio
30/06/2019
Riassunto analitico
A certain number of patients with rotator cuff deficiency progress to end-stage osteoarthritic disease with concomitant pain and loss of function and independence. <br>In 1987 Grammont et Baulot introduced a novel semiconstrained reverse shoulder arthroplasty (RSA) as a treatment for patients with cuff tear arthropathy. It involved reversing the polarity of ball-and-socket by placing a &#34;ball&#34; component at the glenoid and an articular &#34;socket&#34; at the proximal humerus. The geometric inversion of the implanted joint components has two essential biomechanical consequences. Medialization of the center of rotation optimizes the deltoid lever arm. Increasing the subacromial space by lowering the humerus results in an increase in deltoid strength by restoring deltoid tension which corrects rotator cuff deficiencies. Good clinical outcome is achieved through maximization of the length-tension relationship of the deltoid and remaining cuff musculature, and it may allow patients to achieve a good functional result even in the presence of a severely deficient rotator cuff<br>RSA has advanced the treatment of shoulder disorders, the ideal indications, surgical techniques, implant designs, and rehabilitation protocols continue to be refined. <br>With improvements in modern implant design and instrumentation, surgical techniques for RSA continue to evolve, as do the surgical indications. <br>Reverses shoulder arthroplasty is most commonly performed via a deltopectoral (DP) or anterosuperior (AS) approach, and several modifications of each have been described. This work aims to explain our surgical technique of mini invasive tissue-sparing antero superior approach and to examine the related evidence.<br>
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