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Long-term Reverse Total Shoulder Arthroplasty Outcomes: The Effect of the Inferior Shifting of Glenoid Component Fixation

BACKGROUD: The 155° Grammont reverse shoulder replacement has a long track record of success, but also a high radiographic notching rate. The increased distance between the scapular pillar and the humeral component theoretically decreases postoperative notching. The glenoid component can be shifted...

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Autores principales: Collotte, Philippe, Bercik, Michael, Vieira, Thais Dutra, Walch, Gilles
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Orthopaedic Association 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8609210/
https://www.ncbi.nlm.nih.gov/pubmed/34868500
http://dx.doi.org/10.4055/cios20245
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author Collotte, Philippe
Bercik, Michael
Vieira, Thais Dutra
Walch, Gilles
author_facet Collotte, Philippe
Bercik, Michael
Vieira, Thais Dutra
Walch, Gilles
author_sort Collotte, Philippe
collection PubMed
description BACKGROUD: The 155° Grammont reverse shoulder replacement has a long track record of success, but also a high radiographic notching rate. The increased distance between the scapular pillar and the humeral component theoretically decreases postoperative notching. The glenoid component can be shifted inferiorly relative to the glenoid; however, there also is some concern that shifting the glenoid component too far inferiorly (inferior glenoid component overhang > 3.5 mm) may compromise long-term stability of the glenoid component. This study was conducted to determine if clinical outcomes, scapular notching, and complications vary with more inferior placement of the glenoid component. METHODS: A retrospective analysis of prospectively collected data was performed in order to compare radiographic outcomes (notching rate and signs of glenoid loosening or component disassembly) and clinical outcomes (range of motion, Constant score, subjective shoulder value, and complication rate) of all patients who underwent reverse shoulder replacement with the glenosphere positioned either flush with the inferior rim of the glenoid (flush group) or with at least 3.5 mm of inferior overhang (overhang group) at a minimum follow-up of 60 months. Ninety-seven patients ultimately met the inclusion criteria, with 41 patients with flush glenoid component and 56 patients with at least 3.5 mm of inferior overhang. RESULTS: Average follow-up was 97.8 months. The overhang group had a lower rate of radiographic notching (37% vs. 82.5%, p < 0.05), better clinical outcomes (improvement in Constant score: +40 vs. +32, p = 0.036), and higher subjective shoulder value (79 vs. 69, p = 0.026) than the flush group. No difference in complications between groups was found. CONCLUSIONS: In this study, at least 3.5 mm of inferior glenosphere overhang relative to the inferior rim of the glenoid was associated with the lower notching rate without negative effect on the clinical outcomes in 155° Grammont-style reverse shoulder replacement. Therefore, no increase in complications should be expected when using this surgical technique.
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spelling pubmed-86092102021-12-04 Long-term Reverse Total Shoulder Arthroplasty Outcomes: The Effect of the Inferior Shifting of Glenoid Component Fixation Collotte, Philippe Bercik, Michael Vieira, Thais Dutra Walch, Gilles Clin Orthop Surg Original Article BACKGROUD: The 155° Grammont reverse shoulder replacement has a long track record of success, but also a high radiographic notching rate. The increased distance between the scapular pillar and the humeral component theoretically decreases postoperative notching. The glenoid component can be shifted inferiorly relative to the glenoid; however, there also is some concern that shifting the glenoid component too far inferiorly (inferior glenoid component overhang > 3.5 mm) may compromise long-term stability of the glenoid component. This study was conducted to determine if clinical outcomes, scapular notching, and complications vary with more inferior placement of the glenoid component. METHODS: A retrospective analysis of prospectively collected data was performed in order to compare radiographic outcomes (notching rate and signs of glenoid loosening or component disassembly) and clinical outcomes (range of motion, Constant score, subjective shoulder value, and complication rate) of all patients who underwent reverse shoulder replacement with the glenosphere positioned either flush with the inferior rim of the glenoid (flush group) or with at least 3.5 mm of inferior overhang (overhang group) at a minimum follow-up of 60 months. Ninety-seven patients ultimately met the inclusion criteria, with 41 patients with flush glenoid component and 56 patients with at least 3.5 mm of inferior overhang. RESULTS: Average follow-up was 97.8 months. The overhang group had a lower rate of radiographic notching (37% vs. 82.5%, p < 0.05), better clinical outcomes (improvement in Constant score: +40 vs. +32, p = 0.036), and higher subjective shoulder value (79 vs. 69, p = 0.026) than the flush group. No difference in complications between groups was found. CONCLUSIONS: In this study, at least 3.5 mm of inferior glenosphere overhang relative to the inferior rim of the glenoid was associated with the lower notching rate without negative effect on the clinical outcomes in 155° Grammont-style reverse shoulder replacement. Therefore, no increase in complications should be expected when using this surgical technique. The Korean Orthopaedic Association 2021-12 2021-07-02 /pmc/articles/PMC8609210/ /pubmed/34868500 http://dx.doi.org/10.4055/cios20245 Text en Copyright © 2021 by The Korean Orthopaedic Association https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Collotte, Philippe
Bercik, Michael
Vieira, Thais Dutra
Walch, Gilles
Long-term Reverse Total Shoulder Arthroplasty Outcomes: The Effect of the Inferior Shifting of Glenoid Component Fixation
title Long-term Reverse Total Shoulder Arthroplasty Outcomes: The Effect of the Inferior Shifting of Glenoid Component Fixation
title_full Long-term Reverse Total Shoulder Arthroplasty Outcomes: The Effect of the Inferior Shifting of Glenoid Component Fixation
title_fullStr Long-term Reverse Total Shoulder Arthroplasty Outcomes: The Effect of the Inferior Shifting of Glenoid Component Fixation
title_full_unstemmed Long-term Reverse Total Shoulder Arthroplasty Outcomes: The Effect of the Inferior Shifting of Glenoid Component Fixation
title_short Long-term Reverse Total Shoulder Arthroplasty Outcomes: The Effect of the Inferior Shifting of Glenoid Component Fixation
title_sort long-term reverse total shoulder arthroplasty outcomes: the effect of the inferior shifting of glenoid component fixation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8609210/
https://www.ncbi.nlm.nih.gov/pubmed/34868500
http://dx.doi.org/10.4055/cios20245
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