A reverse total shoulder arthroplasty is a prosthesis that should be used in patients who have specific contraindications to the more conventional total shoulder prosthetic replacements. The patient and surgeon should understand that this reconstruction is technically more difficult and is associated with more complications than conventional shoulder reconstructions. The reverse total shoulder arthroplasty has been used in Europe more than in North America, and the experience in Europe is guiding its use in North America. An understanding of the mechanics of the reverse total shoulder arthroplasty and the technical details of its implantation will help in understanding its role in shoulder reconstruction.

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