The Orthobullets Podcast Podiums | Shoulder & Elbow | InlayOnly, Flushlay, Lateralization on Glenoid/Humerus-Primary RSA
Aug 16, 2025
Brad Edwards, a design surgeon for Arthrex, dives into the cutting-edge world of reverse shoulder arthroplasty. He discusses the evolution of implant designs and the critical factors that impact surgical outcomes. The conversation covers the innovative benefits of inlay humeral components and the complexities of glenosphere placement. Edwards shares his expertise on balancing muscle tension for optimal recovery and emphasizes the need for personalized implant solutions to enhance patient outcomes.
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Match Implant To Bone And Cuff
- Use an inlay humeral design when you want stable metaphyseal fixation and easier reduction in small patients.
- Lateralize on the glenoid when cuff is deficient to tension the deltoid and increase impingement-free range of motion.
Physics Still Rules Shoulder Design
- Newtonian mechanics still govern shoulder mechanics: moment arms and forces matter when you change lateralization or length.
- Over-tensioning the deltoid can produce good early elevation but may degrade long-term function due to fatigue.
Avoid Chronic Deltoid Overtensioning
- Avoid chronic deltoid overtensioning because it can cause deterioration in function after several years.
- Aim to restore deltoid tension closer to native length to preserve long-term outcomes.