reverse shoulder

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Yes, if there is enough bone to anchor a reverse....go ahead and redo the procedure after the infection has cleared with an antibiotic spacer. If not, bone graft will be need to reconstruct anatomy for an implant. Most likely a staged procedure over several months.
 












Being a student of reverse for the last few years has been quite an enlightening experience. The Tornier and DePuy reverses all rely on the Grammont theory of a medialized center of rotation. Their humeral stem angle of 155, in combination with the medialized COR have led to huge instances of inferior scapular notching, which in turn can lead to baseplate failure. I have been selling one of the medialized COR systems for a few years. After going to a number of meetings, reviewing whitepapers, listening to the surgeons on development teams for both camps (medial and lateral COR respectively) it has become pretty clear that the old technology (Grammont designs) are becoming obsolete. Mark Frankle (the designer of the Encore reverse) has absolutely the right idea when it comes to reversed mechanics. They had a minor problem with their 1st generation baseplate (too small diameter baseplate screws) and corrected it to a larger screw to provide adequate baseplate fixation. Whenever you hear Tornier/DePuy/etc reps saying they have glenoid problems this is what they are talking about. Their current data (2007+) has less than 1% glenoid failure rate with the new screws. Their humeral component has an angle of 135 (or 130) with a lateralized glenosphere which has a minute incidence of inferior scapular notching. Their reverse on its own miles ahead of anybody else (Biomet is the only real competitor here because they have a modular humeral stem between both primary TSA and RSA respectively) Tornier is trying to combat the lateralized COR by creating something called the BIO RSA in which you take an autograft from the humeral head and placing it behind the glenoid baseplate to lateralize. Pascal Boileau is Tornier's champion shoulder surgeon, he himself said that Frankle was correct, thus they created a dead bone sandwich in an attempt to recreate the Encore mechanics. Encore is the wave of the future, and the clinical data is finally coming to light to support that. If you sell Tornier or DePuy reverses, have fun explaining large amounts of inferior scapular notching to your surgeons.
 






Reverse...my understanding is that medializing the cor preserves fixation of the Glenoid while compromising stability. Lateralizing the cor gives greater stability but compromises the life of the Glenoid fixation. Depuy, for example, has eccentric heads allowing the surgeon to put in a 42 head while dropping it down inferior to the notch. I sell for depuy and my surgeons understand this and have had good results.

Either way...trashing companies like Zimmer or depuy, if you sell encore, make you look like a fool. A lot of our data moving forward is from these two companies research and longevity. Encore, in my Territory saw solid growth in the last two years, however, they also put two surgeons on their payroll. Short term profits, however, other docs are not impressed. With the doj getting stricter I see companies like tornier and encore either getting scooped up by competition like Stryker or simply flattening out.
 






seeing as the original post was made in 2009, much has chanced in the views of reverse shoulders. There's been some studies done on reverse shoulder design that you can look into. Seeing the clear bias comments on this message board I really encourage anyone reading this to do their own research.
 






I'm laughing at all u ass clown. If the surgeon believes in the technology of reverse shoulders at all, it comes down to your relationship w/ the dr at the end of the day. Lets be serious & call a spade a spade. Shoulder replacements only account for 10% of all the total business. Maybe if Tornier had a decent total hip/knee/trauma product they could compete w/ the big boys. Until then, shut the fuck up b/c ur company is a joke to 95% of Orthopedic surgeons
 






Tornier is very well respected. We have expansive sports med and podiatry product lines which have more than made up for our loss of market share in the shoulder. We are also rumored to be entering the urology market, so anyone selling TJR's will be crushed, as that market is now a commodity market. We are focused on high growth markets!
 






Your company will be bought out or absorbed in 5-7 yrs at most. I'm not going to sit here & argue the company's revenues & profits b/c I don't know them, but the way this healthcare industry is going, Tornier won't be able to sustain any serious growth or maintain jobs or be able to put $$$ into R&D w/ this 2.3% excise tax that everyone is being forced to pay to help the indigent population & illegals who just want to keep their entitlement programs & free handouts. Good luck pal
 
























Anonymous said:
I would rank the Zimmer reverse #1. Probably Biomet's #2. The Exactech or the DePuy Extend 3. The Tornier Revese is only ahead of Encore. How's that bonegraft behind the baseplate working for you Tornier? lol
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Quite well, as when the biomechanics require lateralization of the Glenoid in a younger person, the best option is a custom bone graft using the patients own bone.
 












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