Navigating the Complexities of Range of Motion in Reverse Shoulder Arthroplasty: Innovations and Future Directions

Purpose of Review: With the growing popularity and broadening indications for Reverse Shoulder Arthroplasty (RSA), increasing modularity in design and adjustments to each component can enhance postoperative range of motion (ROM), thus expanding treatment capabilities. This review outlines the advancements developed to optimize ROM through modifications in glenoid and humeral components and the integration of computational tools for surgical planning. Recent Findings: Enhancements in glenoid component design aim to mitigate complications like scapular notching and improve ROM, particularly in abduction and external rotation. Modifications to the humeral component, including adjustments in neck-shaft angle and lateralization, also contribute to ROM optimization. The integration of computational modeling and intraoperative navigation is advancing towards a more tailored approach to RSA to increase postoperative ROM. Summary: While RSA has evolved considerably since the introduction of the Grammont prosthesis, current research continues to improve upon implant design and positioning to overcome early design limitations. Modifications such as glenoid lateralization and inferior positioning and humeral neck-shaft angle and lateralization contribute to better postoperative ROM. The integration of these advancements in implant adjustments with computational modeling for surgical planning has the potential to enhance ROM and patient-specific outcomes. Translating these biomechanical improvements into clinical benefit remains a key area for future investigation.