scholarly journals Early Clinical and Radiographic Outcomes of an Augmented Baseplate in Reverse Shoulder Arthroplasty for Glenohumeral Arthritis with Glenoid Deformity

Author(s):  
Jacob M. Kirsch ◽  
Manan Patel ◽  
Akash Singh ◽  
Mark D. Lazarus ◽  
Gerald R. Williams ◽  
...  
2020 ◽  
pp. 175857322091684
Author(s):  
Richard Dimock ◽  
Mohamed Fathi Elabd ◽  
Mohamed Imam ◽  
Mark Middleton ◽  
Arnaud Godenèche ◽  
...  

Background Reverse shoulder arthroplasty (RSA) has revolutionized the management of many shoulder pathologies. Lateralization has become favourable to combat complications (e.g. notching, compromised external rotation), using a metallic, or autogenous bone-graft baseplates – bony increased-offset reverse shoulder arthroplasty (BIO-RSA). We systematically reviewed the literature to determine: Does BIO-RSA improve range of motion and outcome scores? Are notching rates decreased? Does the graft heal? Methods All available prospective studies, trials and case series reporting on BIO-RSA were included. Outcomes were grouped into outcome scores, range of motion and radiographic outcomes. Data were pooled and statistical analysis performed. Results Eight studies reported on 385 RSA – 235 BIO-RSA and 150 standard-RSA (STD-RSA). Follow-up was 20–36 months; average age 74 years. Outcome scores: Constant-Murley and SSV scores showed statistically significant post-operative benefit of BIO-RSA (mean-difference 4.0 (95% confidence interval (CI): 0.79,7.1) and 6.8 (95% CI: 3.8, 9.9)). No Minimal Clinically Importance Difference was surpassed. Range of motion: No difference was found in any direction. Notching: Notching was less likely with BIO-RSA (odds ratio 0.19 (95% CI: 0.10, 0.38)). Healing and loosening: 92% grafts fully healed/incorporated. Loosening rate was 2.4%. Conclusions Literature on BIO-RSA is limited with only one randomised controlled trial (RCT). Weak evidence exists for improved outcome scores. Range of motion is equivocal. Notching rates are significantly lower in BIO-RSA. The graft usually heals.


2018 ◽  
Vol 27 (4) ◽  
pp. 701-710 ◽  
Author(s):  
Giovanni Merolla ◽  
Gilles Walch ◽  
Francesco Ascione ◽  
Paolo Paladini ◽  
Elisabetta Fabbri ◽  
...  

2019 ◽  
Vol 3 ◽  
pp. 247154921984404 ◽  
Author(s):  
Samer S Hasan ◽  
Jonathan C Levy ◽  
Zachary R Leitze ◽  
Avinash G Kumar ◽  
Gary D Harter ◽  
...  

Background We report here on the results, stratified by diagnosis, of a multicenter prospective study by surgeons unaffiliated with the design team of reverse shoulder arthroplasty (RSA) performed using a lateralized glenosphere. We hypothesized that outcomes would be comparable to those reported previously.Methods: A total of 245 patients underwent RSA for cuff tear arthropathy or glenohumeral arthritis with rotator cuff tear, rotator cuff tear with instability or escape and without glenohumeral arthritis, or failed shoulder arthroplasty. Clinical, radiographic, and self-assessed outcome measures were obtained preoperatively and at standardized time points postoperatively. At 2 years, 173 patients were available as 23 patients were deceased, 12 had undergone revision, and 37 were unavailable.Results: Range of motion and outcomes improved, irrespective of diagnosis. Active forward flexion, abduction, and external rotation improved (73°–127°, 65°–109°, and 24°–37°, respectively, P < .0001 for all). Simple Shoulder Test (3.2–8.5) and American Shoulder and Elbow Surgeons scores (45–86) also improved. Scapular notching occurred in 13.3%; scapular spine/acromial fractures in 6.5%. Patients undergoing revision shoulder arthroplasty improved more modestly.Conclusion: In this multicenter study, surgeons unaffiliated with the design team obtained clinical improvements comparable to those reported previously and that exceeded minimal clinically important differences for RSA. Improvements in external rotation and low scapular notching rates potentially relate to the lateralized design.


2014 ◽  
Vol 96-B (7) ◽  
pp. 936-942 ◽  
Author(s):  
C. Middleton ◽  
O. Uri ◽  
S. Phillips ◽  
K. Barmpagiannis ◽  
D. Higgs ◽  
...  

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