The Verso shoulder
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THE VERSO – BONE PRESERVING REVERSE GEOMETRY SHOULDER SYSTEM – PRELIMINARY RESULTS
Ofer Levy, Paul Smirthwaite, Stephen Copeland, Reading Shoulder Unit
Reverse shoulder prostheses are gaining popularity in recent years. Good short term results with restoration of active elevation have been reported. However, high complication rate (24%-50%) reported and many of them require further surgery. Of major concerns are glenoid or humeral shaft fractures on preparation, dislocations and instability and high infection rate. Glenoid notching is a very serious complication, noticed in most cases with Gramont type stemmed prostheses. The amount of bone resected on insertion of these stemmed prostheses makes any future revision surgery very difficult and therefore their use is limited to the very elderly patients.
present the Verso – a novel design of bone preserving stemless reversed geometry prosthesis with minimal bone resection, cementless and bone impaction fixation. The prosthesis was developed following extensive research since 1997 and has been in a clinical use since 2005.
We report our results of the first 41 patients with follow up between 3 years to over 6 months, with excellent and encouraging outcome. 11 male and 30 female, average age 72.2 years (54-93y). 29 for Cuff arthropathy, 6 for fracture sequelae and 6 with Rheumatoid arthritis. 8 were revision cases following previous arthroplasty.
All patients had good pain relief and were very satisfied with their shoulder (8.6/10). Mean Constant Score improved from 8.4 preop to 65.9 postop (17-73.6) with outstanding range of movement with 132.5º elevation, 49.8º external rotation and 63.6º internal rotation. Most of the patients resumed normal daily and leisure activities. Radiographic analysis showed no lucencies around the implants and no glenoid notching so far.
The Verso, shows encouraging excellent preliminary results with no lucencies or glenoid notching. All options remain open for future surgery if deemed necessary as all bone stock is preserved and therefore this prosthesis may be used in younger patients as well.
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