Handling the Unstable RSA: Prevention & Management Mark A. Frankle, MD | SDSI Shoulder Course 2021 скачать в хорошем качестве

Handling the Unstable RSA: Prevention & Management Mark A. Frankle, MD | SDSI Shoulder Course 2021

www.sdsi-shoulder.com How to Handle the Unstable RSA: Prevention and Management, Key Insights: Reverse shoulder replacement offers stability by neutralizing deforming forces, but instability remains a common complication, occurring in up to 30% of cases. Understanding the biomechanics of reverse shoulder arthroplasty (RSA) is crucial to managing instability effectively. Key Causes of Instability in RSA: Inadequate Compression – Insufficient force between the ball and socket reduces stability. Solutions include optimizing humeral offset and lateralizing the glenosphere. Loss of Containment – Damage or wear to the socket reduces contact area, leading to instability. Addressing liner integrity can help. Impingement – Mechanical or soft tissue impingement can restrict motion and cause dislocation. Surgical adjustments can optimize the impingement-free arc. Treatment Strategies: Enhancing Compression: Increase humeral offset or lateralize the glenosphere. Restoring Containment: Replace damaged liners or address impingement sources. Balancing Soft Tissue: Ensure symmetrical tension to prevent postoperative instability. Conclusion: A systematic approach to diagnosing and addressing instability in reverse shoulder replacements improves patient outcomes. Identifying the root cause—compression loss, containment loss, or impingement—is essential for successful management.