The Biomet Comprehensive© Reverse Total Shoulder System Design Considerations and Surgical Techniques

The Biomet Comprehensive® Reverse Shoulder Arthroplasty (RSA) is newer designed third-generation reverse prosthesis. Based on the concept originally developed by Grammont, the Biomet Comprehensive® RSA utilizes initial design of the reverse ball-and-socket implant while adding some newly developed technologic changes in order to avoid specific complications such as scapular notching or baseplate failure. One of these important advances in design, the Versa-Dial® glenosphere, allows for an infinite number of offset combinations in all direction on the glenoid side. When this technology is used in combination with two available sized baseplates, which have improved fixation features, it allows the surgeon to place the implant in the best bone stock and in the best possible position to prevent complications. In addition, the Biomet Comprehensive® Shoulder is based upon the concept of an universal humeral stem component platform system, which allows any humeral stem type or size to be used in this RSA system. It also makes conversion of an anatomic shoulder arthroplasty or fracture hemiarthroplasty (HA) to RSA much easier. This chapter will present the design considerations and biomechanical rationales of the Biomet Comprehensive® RSA. The surgical procedure is presented in details in order to clearly define the different technical steps for successful prosthesis implantation. Finally, newer concepts of implant placement and fixation will be discussed as our efforts to improve this technology continue.

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