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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Lateralization Has Distinct Trade-Offs
- Lateralization source matters: humeral lateralization increases deltoid wrap while glenoid lateralization raises acromial stress fracture risk.
- Understand your implant's limits and plan lateralization accordingly for cuff status and revisions.
Optimize Glenosphere Positioning
- Position the glenosphere to posterior-inferiorly cover the scapular pillar while avoiding anterior overhang to reduce coracoid stress.
- Use preop planning to optimize glenosphere offset and avoid anterior overhang that impairs internal rotation.
Be Ready To Convert Inlay To Onlay
- Plan for an inlay but be ready to convert to onlay intraoperatively if the trial shows instability.
- Ream and test stability; add polyethylene to restore stability rather than rigidly pursuing inlay placement.