fxsolutions

EASYTECH
HUMERIS
LONG
STEM
200mm
HUMELOCK II
HUMELOCK II
REVERSIBLE
HUMELOCK
REVERSED
1 TABLE OF CONTENTS
1. ANATOMICAL REMINDERS OF SHOULDER ARTICULATION
Gleno-humeral articulation
Rotator cuff and biceps
2. PATHOLOGICAL CONSEQUENCES ON ANATOMICAL SHOULDER OMARTHRITIS
Degenerative omarthritis
  Superior glenoid wear
3. THERAPEUTICAL TREATMENT TO OBTAIN A MOBILE AND PAINLESS SHOULDER
4. WHAT IS AN ANATOMICAL SHOULDER PROSTHESIS?
  Principal
Historical
Changing ideas
5. WHAT IS A REVERSED SHOULDER PROSTHESIS?
  Principal
Historical
  Pr Grammont
6. THERAPEUTICAL INDICATIONS
Prosthesis choice
7. ALGORITHME Fx SOLUTIONS
2 GLENO-HUMERAL ARTICULATION
3 ROTATOR CUFF
Rotator cuff has a coaptation role which means it keeps the
humeral head against the glenoid while the muscles
stronger take care of the movements.
4 CENTERED ARTHRITIS
  If arthritis is linked to mechanic
articulation use, it is a centered
arthritis : the bone is damaged but
rotator cuff (muscles) is working.
5 SUPERIOR GLENOID WEAR
  Superior glenoïd wear :
Tears of rotator cuff (muscles).
The humeral head went up is no more
centered against the glenoïd.
6 THERAPEUTICALS TREATMENTS
  REMINDER
It exists orthopaedic treatments however after failure among
those, arthroplasty is used.
  CENTERED ARTHRITIS
Anatomical prosthesis with or without glenoïd arthroplasty.
We rebuild anatomy with existing rotator cuff.
  SUPERIOR GLENOID WEAR
Tears of rotator cuff (supra spinatus) : Reversed prosthesis
7 ANATOMICAL SHOULDER PROSTHESIS
  PRINCIPAL
Anatomical shoulder prosthesis reproducts
natural articulation (anatomy) with humeral
part and glenoïd part. It needs a rotator cuff
in good shape.
HUMELOCK II
Post op X-­‐ray 8 ANATOMICAL REVERSIBLE PROSTHESIS
HUMELOCK II
REVERSIBLE
Post op X-­‐ray 9 ANATOMICAL SHOULDER PROSTHESIS
  HISTORICAL
The first shoulder prosthesis has
been created in 1893.
HUMELOCK II
Charles Neer put the first anatomical shoulder
prosthesis on a fracture, in vitallium, monobloc,
and reproduce the anatomy of the humeral
epiphysis with a head size 44 (Neer I).
10 ANATOMICAL SHOULDER PROSTHESIS
  CHANGING IDEAS
To keep the maximum of bone, stemless
have appeared few years ago. The
results are astonishing.
The conversion in reversed prosthesis is
possible in case of rotator cuff damage.
EASYTECH
Post op X-­‐ray 11 ANATOMICAL REVERSIBLE PROSTHESIS
HUMERIS
REVERSED
ANATOMICAL
12 Pr. Paul GRAMMONT (1940-2013)
  In 1985, Grammont designed a
reverse prosthesis for arthritic
shoulders with severe destruction
of the cuff, in which standard
anatomic prostheses could not
solve the problem of restoring both
joint stability and mobility.
  He published his first paper on the
reverse prosthesis in the French
literature in 1987.
  The concept of the reverse
prosthesis developed by
Grammont was a major step
forward in the field of shoulder
arthroplasty.
13 REVERSED SHOULDER PROSTHESIS
  PRINCIPAL
The male part will be fixed on the scapula
and the female part on the humerus.
This design is used to stabilize the
articulation and work without the rotator cuff.
However, we keep the tuberosities to insure
a better mobility and stability in trauma.
Post op X-­‐ray HUMELOCK
REVERSED
14 REVERSED SHOULDER PROSTHESIS
EASYTECH
REVERSED
Post op X-­‐ray 15 REVERSED SHOULDER PROSTHESIS
  HISTORICAL
The story of the reverse starts in 1970 with the
prosthesis of Neer-Averill.
1972: Reeves
1972: Gérard and Lannelongue
1973: Kölbel
1973: Kessel
1973: Bayley-Walker
1975: « Jefferson » of Fenlin
1975: « Liverpool » of Beddow
1978: Buechel-Pappas-De-Palma
1978: Gristina
1985: 1st model of Grammont
1989: 2nd model of Grammont
2011: Humelock Reversed of Tristan Lascar
and Laurent Obert
HUMELOCK
REVERSED
16 THERAPEUTICALS INDICATIONS
The choice of implanting a prosthesis will be defined in
function of several parameters :
Failure of a medical treatment well conducted
 Causes of the articulation destruction
Bone and cartilage wear out
Rotator cuff tears
 Age, health, sickness
 Exams results
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