DELTA XTEND Reverse Shoulder System

Division: Shoulder
Category: Shoulder Reconstruction

The DELTA XTEND System is a total semi-constrained shoulder arthroplasty. It reverses the normal relationship between the scapular and humeral components, moving the scapulo-humeral joint center of rotation medially and inferiorly. By doing this, it increases the deltoid lever arm as well as the deltoid tension therefore allowing the muscles of the deltoid group to compensate for rotator cuff deficiency. Each design feature of the Delta XTEND Reverse Shoulder System was chosen to accelerate recovery, optimize function and maximize survivorship.

The DELTA XTEND Shoulder Monobloc Humeral Stem is designed for cemented fixation, while the Modular Humeral Stem is designed for cementless fixation.  The glenoid component is cementless with four screws as primary fixation and HA coating for secondary fixation.

Indications for Use

The DELTA XTEND Shoulder Prosthesis is indicated for use in a grossly deficient rotator cuff joint with:

  • severe arthropathy and/or
  • a previously failed joint replacement, and/or
  • fracture-dislocations of the proximal humerus where the articular surface is severely comminuted, separated from its blood supply or where the surgeon’s experience indicates that alternative methods of treatment are unsatisfactory

The patient’s joint must be anatomically and structurally suited to receive the selected implant(s), and a functional deltoid muscle is necessary to use the device.

DELTA XTEND hemi-shoulder replacement system is also indicated for hemi-arthroplasty if the glenoid is fractured intraoperatively or for revision of a previously failed DELTA XTEND Reverse Shoulder.

The metaglene component is HA coated and is intended for cementless use with the addition of screws for fixation.

The modular humeral stem and epiphysis components are HA coated and intended for cementless use.

All other components are intended for cemented use only.

WARNING: This product has labeling limitations. See package insert for complete information.

Features & Benefits

  Features Benefits
Cementless Modular Humeral Implant • Fluted stem design based on the GLOBAL® Shoulder Stem Design - positioned in anatomic version for optimal press-fit fixation1
• Hydroxyapatite (HA) coated titanium alloy for cementless application2
• Positioned at 0-10° retroversion for increased internal rotation3
• Centered and eccentric options to suit to anatomy and optimize press-fit fixation
• 155° neck shaft angle for optimal joint stability4
• Reduced dimensions for bone preservation
Cemented Monobloc Humeral Implant • Polished cobalt chromium alloy for optimized cemented fixation5
• 155° neck shaft angle for optimal joint stability4
• Reduced proximal geometry for bone preservation
• Standard and long monobloc stems with smooth, perforated fins and proximal height laser markings for use in proximal bone loss cases
Polyethylene Humeral Cups • +3, +6 and +9mm cup sizes are available to adjust joint tension for optimal deltoid function based on clinical heritage6,7
• High Mobility Cups available in PREMIERON®X-linked Polyethylene
Glenoid Component
• Increased glenosphere diameter (38mm and 42mm) and eccentric option for improved stability, maximized range of motion and reduced risk of scapular erosion8
• Center of rotation on glenoid bone surface for high resistance to loosening shear forces7,8,9
• Two locking variable angle screws (compress and lock) and two compression screws with +/- 10 degrees adjustable angulation for metaglene primary fixation, to maximize resistance to loosening shear forces9
• Curved back and smaller metaglene, for bone preservation and low positioning on the glenoid to reduce risk of scapular bone erosion8,9
• Standard (13.5mm) and Long Peg (+10mm and +15mm) Metaglenes allow for primary, revision and bone grafting
• Hemi-heads available in two diameters and two head heights for easy revision from reverse to hemi-arthroplasty
• Extended head design allows an increased surface area for osseous contact and may decrease impingement of the greater tuberosity10

1. Wirth, M.A., et. al. “Compaction Bone-Grafting in Prosthetic Shoulder Athroplasty.” Journal of Bone Joint Surgery 2007.

2. Head, W.C., et. al. “Titanium Alloy as a Material of Choice for Cementless Femoral Components in Total Hip Arthroplasty,” Clinical Orthopaedics and Related Research 1995.

3. Karelse, A.T., et. al., “Prosthetic Component Relationship of the Reverse Delta III Total Shoulder Prosthesis in the Transverse Plane of the Body”, Journal of Shoulder and Elbow Surgery 2008.

4. Boileau, P., et. al. “Grammont Reverse Prosthesis: Design Rationale and Biomechanics.” Journal Shoulder Elbow Surgery 2005.

5. Collis, D., et. al. “Comparison of Clinical Outcomes in Total Hip Arthroplasty Using Rough and Polished Cemented Stems with Essentially the Same Geometry.” Journal of Bone and Joint Surgery. ORG, 2002.

6. Sirveaux, F., et. al. “Grammont Inverted Total Shoulder Arthroplasty in the Treatment of Glenohumeral Osteoarthritis With Massive Rupture of the Cuff. Results of a Multicenter Study of 80 Shoulders.” Journal of Bone Joint Surgery Br 2004.

7. De Wilde, L.F., et. al. “Shoulder Prosthesis Treating Cuff Tear Arthropathy: A Comparative Biomechanical Study.” Journal of Orthopedic Research 2004.

8. Middernacht, B., et. al., “Consequences of Scapular Anatomy for Reversed Total Shoulder Arthroplasty”, Clinical Orthopaedics and Related Research 2008.

9. Data on file, DePuy France DHF, 2006.

10. Visotsky, J. “Cuff Tear Arthropathy: Pathogenesis, Classification and Algorithm for Treatment.” The Journal of Bone and Joint Surgery 86, 2004:35-40.


All medical devices have associated risks. Please refer to the package insert and other labeling for a complete list of indications, contraindications, precautions and warnings. For further information on DePuy Synthes Products, please contact your local DePuy Synthes Representative.