REVERSE SHOULDER ARTHROPLASTY. HISTORY AND DEVELOPMENT PROSPECTS

In elderly patients with a low bone mineral density primary endoprosthesis shoulder joint is one of the methods surgical treatment. Goal. Perform historical review development reverse arthroplasty (RSA) analysis biomechanical features existing implants, their advantages and disadvantages to identify possible areas for further ways improvement. Methods. Search scientific information was performed in electronic databases PubMed, ScienceDirect, Google Scholar search depth 30 years. There were selected 68 sources. Results. Unsatisfactory results after hemiarthroplasty caused severe damage rotator cuff multifragmental fractures proximal humerus using RSA. Endoprosthesis design C. Neer replaced implants P. Grammont design, built on principles: spherical glenoid component, concave support part humerus, center rotation at level or medially scapular neck, displaced distally. Medialization anunfavorable factor that leads loss tension deltoid muscle. To eliminate this disadvantages, lateralized hemispheres have been developed, help which stability achieved, formation defect lower edge neck prevented. Their size affects volume movements: smallest diameters should be used prevention soft tissue strain. Note use RSA varus component brings biomechanics closer normal anatomical features. Conclusions. The main directions improvement: conducting research evaluate structures endoprostheses order choose optimal design; introduction modern additive technologies will allow obtain porous components increased osteointegrative properties; reduce weight hemisphere; improving friction pairs