Comprehensive® Reverse Shoulder System

Proven. Versatile. Simple.

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The goal was simple.

The Comprehensive Reverse Shoulder System was born from a desire to provide a complete shoulder arthroplasty solution to surgeons, without compromise.

Now, this spirit of innovation lives on through evolved solutions for challenging cases, including Comprehensive Vault Reconstruction System (VRS), Segmental Revision System (SRS) for reverse and anatomic, Augmented Baseplates and Mini Humeral Trays and Bearings.

Confidently approach clinical challenges with proven technologies, versatile innovation and market-leading simple solutions in the Comprehensive Reverse Shoulder System.

 

PROVEN

Clinical History

The Comprehensive Reverse Shoulder has been trusted since 2008. It has a proven1-12 clinical history, and combines materials that have been tested to withstand the demands of joint arthroplasty. Common clinical challenges such as scapular notching, a more demanding patient population and polyethylene wear were inputs of the original design rationale, and Comprehensive Reverse provides the answers.

VERSATILE

Full Suite of Glenoid Solutions

The glenoid is traditionally the most difficult part of a reverse shoulder procedure due to poor visibility of the scapula for assessment of the glenoid vault and glenoid version, minimal bone for fixation of the implants and determination of deltoid tensioning.  The surgery can become even more difficult with moderately to severely eroded glenoids. In order to address a wide range of possible patient anatomies, the Comprehensive Reverse System provides one of the most complete glenoid portfolios on the market and includes Mini and Standard Baseplates, Augmented Baseplates, Vault Reconstruction System and compatibility with Trabecular Metal™ Reverse System to solve any glenoid deficiency that comes your way.

SIMPLE

Instrumentation

Instrumentation can make big difference in a surgery. Good instrumentation should allow the patient and implant to come into focus. Comprehensive Reverse instrumentation was designed to be intuitive and complement the surgical work flow.

Humeral Stems

  • Titanium with proximal PPS® porous plasma spray
  • Convertible from anatomic (total) shoulder to reverse
  • 45°/135° anatomic neck-shaft angle
  • Four lengths: Micro, Mini, Standard and Revision
  • 4 – 20 mm diameters, in 1 mm increments
  • Fracture stem and SRS
  • 69 stem sizes
  • For use with or without bone cement

Mini Humeral Trays

  • Cobalt Chrome or Titanium
  • 40 mm diameter
  • Three height options (+0, +5, +10 mm)
  • Three offset posts options (+0, +3, +6 mm)

Mini Humeral Bearings

  • Vivacit-E® or Prolong® Highly Cross-Linked Polyethylene
  • Three height options (+0, +3 mm or +3 Retentive)
  • SIM-Loc™ Technology
  • Final Humeral Tray/Bearing inclination angle at 57°/147°

Baseplates

  • Modular design of baseplate and central screw allows for proper orientation of peripheral screw holes prior to impaction and the Central Boss provides for enhanced fixation and resistance to shear forces
  • Hydroxyapatite (HA) over PPS® porous plasma spray, over Titanium substrate
  • Mini Baseplate: Low-profile 25 mm diameter
  • Standard Baseplate:  28 mm diameter
  • Four identical peripheral locking screw holes

Augmented Baseplates

  • Designed with posterior half-wedge to maximize bone preservation.  
  • Superiorly directed Augment Baseplate may preserve subchondral bone and restore a natural, lateralized center of rotation benefitting soft tissue tensioning and stability
  • Available in small, medium and large.

Glenospheres

  • Constructed from Cobalt-Chrome or Titanium. Available in 36 mm or 40 mm diameter of curvature medialized or lateralized center of rotation (Standard, +3 mm, +6 mm)
  • Versa-Dial® technology to provide infinite offset options between 0.5 and 4.5 mm and can be positioned in any direction*

* 36 Glenosphere offset is between 0.5 and 3.5 mm

Screws

  • Modular 6.5 mm Central “compression” Screw, in lengths of 20–50 mm, in 5 mm increments, made from Titanium
  • 4.75 mm Fixed-Angle Locking and Variable-Angle Non-Locking Screws, in lengths of 15–45 mm, in 5 mm increments, made from Titanium
  • Ability to target good bone with 12° of screw angulation with non-locking screws
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References

  1. Vivacit-E Vitamin E Highly Crosslinked Polyethylene Long-Term Performance for High Demand Patients.  Zimmer Technical Memo, 2014.  Literature # 97-7255-181-00 Rev 1. (Laboratory studies are not necessarily indicative of clinical performance.)
  2. Peiserich M, et al. Retention of Mechanical Properties in a Blended Vitamin E Polyethylene After Extreme Oxidative Challenge. Poster 1060, ORS 2013 Meeting. 2013. (Laboratory studies are not necessarily indicative of clinical performance.)
  3. Mimnaugh,K. et al. 100 Million-Cycle Wear Evaluation of Crosslinked Vitamin E Grafted Polyethylene (VE-HXPE) Acetabular Liners. Paper No. 0403. ORS 2016 Annual Meeting (Laboratory studies are not necessarily indicative of clinical performance.)
  4. Zimmer Prolong Highly Crosslinked Polyethylene Brochure.  Literature #: 97-5952-101-00 Rev 2. (Laboratory studies are not necessarily indicative of clinical performance.)
  5. Xinning L, Dines J, Warren R, Craig E, Dines D.  Inferior Glenosphere Placement Reduces Scapular Notching in Reverse Total Shoulder Arthroplasty. Orthopedics. 2015; 38(2):e88-e93.
  6. Jost, Patrick W, Dines, Joshua S, Griffith, Matthew H, Angel, Michael, Altcheck, David W, Dines, David M.  Total Shoulder Arthroplasty Utilizing Mini-Stem Humeral Components: Technique and Short-Term Results.  HSSJ (2011) 7:213-217.
  7. Wagner, Eric R, Statz, Joseph M, Houdek, Mathew T, Cofield, Robert H, Sanchez-Sotelo, Joaquin, Sperling, John W.  Use of a shorter humeral stem in revision reverse shoulder arthroplasty.  J Shoulder and Elbow Surg. 2017.
  8. S.A. Guiseffi, P Streubel, J. Sperling, J. Sanchez-Sotelo. Short-stem uncemented primary reverse shoulder arthroplasty.  The Bone & Joint Journal.  2014; 96-B: 526-9.
  9. Comprehensive Reverse Shoulder Post-Market Clinical Study (Protocol EX007).  September 2018 Annual Report.
  10. Werner B, Dines J, Dines D. Platform systems in shoulder arthroplasty. Curr Rev Musculoskeletal Med. 2016.
  11. Williams P, Trehan S, Tsouris N, Dines J, Dines D, Edward C, Gulotta L, Warren R. Functional Outcomes of Modular Conversion of Hemiarthroplasty or Total to Reverse Total Shoulder Arthroplasty.  HSS Journal. 2017.
  12. Wiser K, Borbas P, Ek E, Meyer D, Gerber C.  Conversion of Stemmed Hemi-or Total to Reverse Total Shoulder Arthroplasty: Advantages of a Modular Stem Design.  Clin Orthop Relat Res; 2015; 473:651-660.

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Zimmer, Inc.
1800 West Center Street
Warsaw, Indiana 46580
USA

Biomet Orthopedics
P.O. Box 587
56 E. Bell Drive
Warsaw, Indiana 46581-0587
USA

 

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