Restoration of External Rotation Following a Lateral Approach for Glenoid Bony Increased-Offset Reverse Shoulder Arthroplasty

Reverse shoulder arthroplasty (RSA) is a recognized therapeutic modality for a massive rotator cuff tear. Some authors recommend lateralization of the center of rotation by bony increased offset (BIO) of the glenoid for improvement of external rotation, while others refute its effects. RSA through the conventional deltopectoral approach sacrifices the subscapularis tendon during the approach. We hypothesized that a lateral approach (LA) for RSA, with less soft-tissue resection, would restore external rotation by allowing retensioning of the remaining rotator cuff with use of a BIO graft.