The Delta XTEND™ Reverse Shoulder System
The Delta XTEND System is designed for people who have “end-stage cuff tear arthropathy,” a medical condition in which the rotator cuff muscles (the muscles around the shoulder joint) have degenerated, or weakened to a point where they can no longer hold the shoulder joint intact or allow it to function normally in conjunction with arthritis. This instability, or looseness, in the presence of arthritis can cause extreme pain and loss of movement of the shoulder.
In many cases, the causes of the weakness may be arthritis, a previous shoulder injury such as a shoulder fracture, rotator cuff tear and/or failed previous shoulder surgeries.
What does Reverse Shoulder System mean?
The Delta XTEND Reverse Shoulder System is a procedure for people who have exhausted all other means of repair of their degenerated shoulder. When a person gets to this stage of shoulder instability and pain, it is necessary to make changes in the actual mechanics, or workings, of the shoulder.
In the healthy shoulder, the upper arm bone (humerus) ends in a ball shape. This fits into a socket formed by the shoulder blade (scapula). Together this ball and socket are called the glenohumeral joint more commonly known as the shoulder.
In the Delta XTEND Reverse Shoulder System, the anatomy, or structure, of the healthy shoulder is reversed. The implant is designed so that the ball portion is attached to the scapula and the socket is placed at the upper end of the humerus.
Why reverse the anatomy?
People who have the type of muscle weakening and the loss of function that is consistent with end-stage cuff tear arthopathy often need to have their shoulder re-aligned. As a result the stronger muscles in other parts of the shoulder can do the work of the joint more efficiently. Also, this change in the mechanics of the shoulder and use of stronger muscles will hold the parts of the implant together more tightly than the injured shoulder could, thus making the joint more stable and less likely to experience dislocation.
What does the Delta XTEND Reverse Shoulder System look like?
The Delta XTEND Reverse Shoulder System consists of five basic parts, or components. The upper portion of the humeral stem is called the epiphysis and it lies even with the top of the humerus. It is made of stainless steel. The bottom portion of the humeral stem is called the diaphysis and it is inserted down into the center of the humerus.
The epiphysis holds the third component, a polyethylene cup that forms the socket part of the new joint.
On the scapular side, the fourth component, the metaglene, is a specially coated metal plate that is firmly attached to the scapula with screws.
The fifth component is the ball portion of the joint called the glenosphere. It is a half-globe shaped metal piece that fits onto the metaglene. The glenosphere fits inside the polyethylene cup on the humeral side to form a new shoulder joint. Both the glenosphere and the polyethylene cup come in different sizes so the implant may be tailored to different body sizes.
Who should receive a Delta XTEND Reverse Shoulder System?
The Delta XTEND Reverse Shoulder System is generally used in people who are 70 years old or older and who have significant pain and little to no movement in their shoulder. It is not recommended for people who have bone disease, deficiencies in the scapula, or for patients who do not have functioning deltoid muscles.
It is also not recommended for younger or physically active patients.
What are the benefits of the Delta XTEND Reverse Shoulder System?
The Delta XTEND Reverse Shoulder System has been used for over 15 years in Europe and has demonstrated restored motion, pain relief and stability when implanted by trained surgeons in the appropriate patients. The materials used in the implant have been proven reliable and offer a long implant life. Reversing the anatomy of the shoulder and using the healthy deltoid muscle can restore pain-free shoulder function in end-stage cuff tear arthopathy patients and can help patients return to their daily activities.
Who should perform my shoulder replacement surgery?
Any surgical procedure involves a certain amount of risk and should be entered into accordingly; shoulder replacement surgery is no different. Physicians who treat end-stage cuff tear arthopathy with a shoulder replacement must be experienced shoulder arthroplasty surgeons.
Surgeons are required to attend training prior to implanting the Delta XTEND Reverse Shoulder System. Inquire and make certain that your surgeon has been specifically trained to implant the Delta XTEND Reverse Shoulder System before undergoing this procedure.
Last Updated: 08/29/2008
