Dr Philippe Collin, shoulder specialist, can offer two different types of implant for shoulder osteoarthritis: a total anatomic shoulder replacement or a total reverse shoulder replacement, in which the positions of the head and of the glenoid are reversed compared with their anatomical position. Reverse total shoulder replacements were initially reserved for osteoarthritis linked to failure of the rotator cuff, but the boundaries are now less clear-cut and a reverse total shoulder replacement can be considered even when the rotator cuff is intact.

The decision is based on a precise analysis of the patient's anatomical data, such as glenoid retroversion, which is essential in order to make the most appropriate choice.

For this purpose, 3D analysis software has recently become available and provides precise preoperative information. Beyond this valuable analysis, this software also makes it possible to plan and guide the reverse total shoulder replacement, so as to reproduce the planned procedure as faithfully as possible.

A methodical and precise analysis of the results of the past thirty years has given us a better understanding of the criteria for good outcomes. Considerable progress has been made in recent years.

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