In order to improve results of shoulder arthroplasty in cuff deficient shoulders constrained or reverse arthroplasties were tried. However, the results were unpredictable until the unique design of the Delta reverse shoulder by Professor Grammont. This arthroplasty, with a large hemisphere on the glenoid side resulting in a medialized centre of rotation, has shown very good results in short- and mid-term follow-up studies. It is now routinely used for a variety of different shoulder pathologies where the function of the rotator cuff is lost. Active elevation and abduction is restored together with excellent pain relief. Active external rotation, however, is not restored and therefore the procedure has been combined with muscle transfer in selected patients. This is a review of the history, indications, results and complications of the reverse arthroplasty.
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