General US Market Report for Shoulder Reconstruction Device Contents
– Market Analyses include: Unit Sales, ASPs, Market Value & Growth Trends
– Market Drivers & Limiters for each chapter segment
– Competitive Analysis for each chapter segment
– Section on recent mergers & acquisitions
A total reconstruction of the shoulder involves replacement of the glenoid fossa and the humeral head, thus replacing both sides of the joint. Anatomic shoulder implant procedures had been the most popular in the United States, but were surpassed by reversed shoulder implants. Reversed-shoulder implants are a variation of anatomic devices. Conventionally, anatomic implants mimic the body’s anatomy as they are built as ball and socket joints with the glenoid side operating as the socket.
As the name implies, reversed-shoulder devices switch the ball and socket arrangement. Reversed devices place the socket on the humeral side rather than the glenoid side. This arrangement provides greater stability than a conventional implant and allows the larger deltoid muscle to play a greater role in lifting the arm over the rotator cuff muscles. Hemi shoulder reconstruction, also known as a partial shoulder reconstruction, replaces the humeral side of the joint leaving the glenoid intact. Hemi reconstruction is most often used for humeral head fractures in the absence of glenohumeral arthritis. Many of the components used in hemi systems are the same as those used for total joint replacements. Press-fitting an implant is possible if the quality of existing bone is sufficient; otherwise, the use of bone cement is required for fixation. Similar to other resurfacing procedures, shoulder resurfacing aims to reduce the amount of tissue disruption and replacement. The implant is shaped like a cap with a short stem. To a certain extent, it covers rather than replaces the humeral head, providing a new articulating surface for the shoulder joint. This makes it suitable for arthritic conditions, but not appropriate for cases where the rotator cuff is damaged. Few shoulder devices are sold specifically for the purposes of revising worn primary implants. All-polyethylene glenoid components anchored by pegs tend to have the best durability. Keel anchors tend to fare slightly worse. Metal-backed polyethylene devices implanted with cement historically have had the lowest levels of durability. This is because of the incompatibility in strength and elasticity between the bone and the metal component and because these components are typically used for patients with lesser quality bone stock. The newer generation of these devices has focused on improving the metal bone interface, with porous tantalum being the most promising material.
The shoulder is a highly mobile joint that is also inherently unstable to allow for range of motion. This joint is anchored by muscular attachment to the spine in the back and to the sternum (breastbone) through the clavicle (collarbone). The shoulder is not involved in direct load bearing articulation with the axial skeleton.
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